Foreign body esophagus

Interesting case Patient 9yo was received to ENT ward through call from peads ward. Pateint was having complaints of chest pain and foreign body ingestion. According to the patients attendant she ingested a coin unintentionally. So the patient was kept under observation as a coin would usually go into faeces. But today was 4th day of admission and CXR showed coin still stuck at the same place. Our doctors became doubtfull and recalled the pateints attendant. Our doctors were thinking it might be a cell(battery) mistaken by a coin. So further questioning revealed it was a cell from a calculator. We got alert and asked the patient to be shifted to OT as the cell is very dangerous and might have caused alkali reaction. Pateint was given general anesthesia and prepared for oesophagoscopy. Oesophagoscopy revealed significant granulation tissue, fresh wound, sloughed mucosa but no deep ulcers found. The coin/cell was not seen and findings were noted. And patient is sent to repeat CXR as the cell might have been dislodged . Now further workup is to be planned after the CXR. But today i saw the importance of history and how a wrong history could lead to terrific misled diagnosis and treatment. If a day or two late, the cell would have caused perforation and it would have been really challenging to treat the complications.