Aluminum Coins in Esophagus: A Diagnostic Challenge

The common coins in circulation in Pakistan are of denominations 1, 2 and 5 rupees. Rupee 1 coin (composed of bronze and aluminum and brownish in color) and Rupee 2 coin (composed of brass and aluminum and yellowish in color) were issued in September 1998 by State Bank. While rupee 5 coin (composed of copper and nickel and white in color) was issued later in December 2002. These coins, by composition, were radio-opaque; thus could be detectable by radiographs. In November 2008, State Bank of Pakistan issued Re 1 and 2 aluminum coins of the same diameter and design but of lighter weight because of the low cost at production. The peculiar characteristics of aluminum make these coins faintly visible on usual radiographs and if the radiograph is over exposed, they are almost undetectable (Fig.1) [4].