Swallowing small, non-food items, especially coins, is common, particularly among children. While most ingested coins pass naturally through the digestive system, the event is never harmless. Understanding the penny’s path and recognizing signs of complication are paramount for ensuring safety, due to the potential for obstruction or chemical reaction.
The Immediate Danger: Airway Obstruction
The most immediate, life-threatening danger occurs if the penny is routed into the trachea (windpipe), causing a sudden, complete airway blockage. This is an immediate medical emergency requiring swift action, such as the Heimlich maneuver or calling emergency services. Signs of obstruction include the inability to speak, difficulty breathing, a weak cough, or blue discoloration of the skin. If the coin compresses the trachea, stridor—a high-pitched, noisy breathing sound—may also be present. Once the penny passes into the esophagus (food pipe), the immediate threat to breathing is generally over.
The Typical Digestive Journey and Passage
If the penny successfully passes into the esophagus, its journey through the gastrointestinal tract is usually uneventful. The coin moves into the stomach, where its smooth, rounded shape typically prevents mechanical damage. Muscular contractions and the acidic environment move the coin onward into the small intestine and then the large intestine. The penny is carried along by peristalsis (natural muscular contractions of the bowel). While transit time is highly variable, most swallowed coins pass out in the stool within a few days to a week, though passage may take up to a month in some cases.
When Things Go Wrong: Signs of Complication
The most significant risk posed by a lodged penny relates to its composition, particularly U.S. pennies minted after 1982. These coins are primarily zinc, coated with copper, making them corrosive if retained. The stomach’s highly acidic environment rapidly erodes the copper shell, causing the zinc core to react with gastric acid. This reaction creates highly corrosive zinc chloride, which causes local tissue damage.
If the penny remains stuck in the stomach for more than a few days, zinc leaching can cause severe gastric irritation, inflammation, and ulceration (zinc toxicity). Symptoms include persistent vomiting, abdominal pain, and poor appetite. High levels of systemic zinc absorption can lead to kidney and liver dysfunction, though this is more common with prolonged or multiple ingestions. Other signs of complication include excessive drooling or an inability to swallow, suggesting the coin is lodged in the esophagus. If the coin causes bleeding or obstruction further down the tract, symptoms may include bloody or black, tarry stools, fever, or signs of bowel blockage, such as severe abdominal pain. Any of these symptoms warrant immediate medical attention, even if the ingestion occurred days prior.
Medical Intervention and Removal Procedures
Following a known or suspected ingestion, the first step is typically a radiographic evaluation, such as an X-ray. Since pennies are radiopaque, the X-ray confirms the coin’s presence and exact location (esophagus, stomach, or intestine), guiding the medical team’s next steps. A coin lodged in the esophagus, especially for over 24 hours or if the patient is symptomatic, requires prompt removal to prevent tissue damage. Removal is usually done via endoscopy, where a flexible tube with a camera is passed down the throat. Specialized tools on the endoscope grasp and retrieve the coin.
If the coin has passed into the stomach and the patient is asymptomatic, observation is recommended, as the coin is expected to pass naturally. Endoscopic removal is performed if the coin has not moved from the stomach into the small intestine after several weeks, or if there is radiographic evidence of corrosion. If the coin has entered the small intestine, observation continues. Surgical removal is reserved only for rare cases where the coin causes a complete intestinal obstruction.