Penny In Stool: What Parents Need to Know - Health Risks & What to Do

If a child swallows a penny (or any coin), seek medical evaluation immediately—even if asymptomatic.

Why It’s Urgent

• Esophageal impaction: Coins lodge at cricopharyngeus (C5), aortic arch (T4), or LES (T10). Causes drooling, refusal to eat, chest pain, respiratory distress. Requires endoscopic removal within 24 hrs (sooner if symptomatic).
• Zinc toxicity: Post-1982 pennies are 97.5% zinc with thin copper plating. Gastric acid erodes copper → zinc absorption → hemolysis, anemia, liver/kidney failure, death. This is a medical emergency.
• Intestinal obstruction/perforation: Rare for single coin, but possible if multiple or pre-existing stricture.

Management

1. X-ray (AP + lateral chest/abdomen): Locate coin. Radiopaque.
2. In esophagus: Urgent endoscopy (preferred) or Foley balloon extraction (by experienced physician).
3. In stomach: If <2 cm (penny = 1.9 cm), may pass spontaneously. Serial X-rays q1–2 wks. Endoscopic removal if >4 wks, symptomatic, or zinc toxicity concern.
4. Beyond duodenum: Usually passes. Monitor stools. X-ray if not passed in 4 wks.

Prevention

Keep coins, button batteries, magnets, small objects out of reach of children <3 yrs. Button batteries cause catastrophic esophageal necrosis in 2 hrs—even more urgent.

Never "wait and see" with a swallowed penny. Call your pediatrician or go to ER now.