Foreign Body and Caustic Ingestion in Children

What this deck covers

Foreign Body and Caustic Ingestion in twelve illustrated clinical cases with worked explanations – case presentations built around clinical images, radiology, teaching illustrations and real laboratory data, with the reference range beside every value a case quotes. This visual, data-interpretation style of practice suits candidates preparing for MRCPCH AKP in particular, alongside Saudi and Gulf licensing examinations such as the Arab Board, DHA and OMSB. Each case gives you a clinical vignette, four options, the correct answer, and an explanation of why each of the other three is wrong.

The twelve cases, in order

1. Face-on at the thoracic inlet
2. The second ring
3. Already past the diaphragm
4. Two, not one
5. Ten minutes after the drain cleaner
6. Solids stick, six weeks later
7. The steak that would not go down
8. An open pin, point upwards
9. The same battery, one floor down
10. Six weeks of not eating
11. Ten days after it came out
12. The fourth time this year

What this deck teaches

• Two questions decide everything – what, and where. A coin in the stomach needs nothing, the same coin in the oesophagus needs a scope today, and the rules change completely for batteries, magnets and sharp objects.
• Face-on on the front film means oesophagus. The oesophagus holds a disc in the coronal plane; an object in the trachea turns edge-on. Look at the rim before you call it a coin.
• A second ring is a battery, and the clock started at ingestion. An oesophageal button battery is removed within two hours, because a full-thickness burn begins in that time and keeps deepening after removal.
• The battery rule inverts below the diaphragm. Under 20 mm in a child over five and asymptomatic, it is followed to passage – not an emergency, and not an anaesthetic.
• One magnet is a coin, two are a surgical emergency. They attract across bowel walls and necrose the tissue between them, so a completely well child still needs urgent removal.
• With caustics the management is a list of refusals. Nothing down, nothing up: no neutralising, no induced vomiting, no blind tube – and endoscopy at 12 to 24 hours, because the mouth does not predict the oesophagus.

Exam pearls from this deck

• A disc seen face-on is in the oesophagus. Look at its rim before you call it a coin.
• A disc in the oesophagus with a second ring is a battery, and the clock started when it was swallowed.

The twelve worked cases in this deck, with the images and the full explanation of every option, are part of Pediatric Case Review membership. See what is included, or start with the free Pediatric Exam Review Sets.

More from this system: all gastroenterology illustrated case decks · gastroenterology board questions for bank-style drilling · the free Pediatric Exam Review Sets · pediatric reference values.