Stacked coins ingestion and double rim sign on x-ray: A case report and review of literature

Young children are known for their curious ways of exploring their surroundings. As a normal part of their development, they use all senses to familiarize themselves with new objects. Every new texture, smell, color, or taste will naturally attract a child and entice them to further explore. This instinctive behavior can however lead a child into harm’s way. The same curiosity that enhances their development can also pose a risk of accidental ingestion of foreign body [1,2]. These incidences become dangerous and complications vary in severity depending on the type of foreign body ingested, the duration until the time of presentation and site of impaction [1,2]. The most common objects accidently ingested by children are coins. However, many of these incidences are unwitnessed by the child’s guardians. An x-ray revealing a coin shaped object may in fact be something far more dangerous, such as a button battery. Button batteries are easily accessible to children as they are found in different toys and electronic devices. Due to their higher risk of causing complications, prompt intervention is required. A button battery appears as a circular, radiopaque object with a double halo or rim on an anteroposterior (AP) x-ray film [3,4]. However, these characteristics do not always confirm that the object is in fact a button battery. In our case, we are going to show that sometimes the double rim seen on an x-ray can be attributed to other types of ingested foreign bodies.