Oesophagitis, caustic ingestion and oesophageal injury — structured clinical encounter

Station brief (candidate)

You are the paediatric registrar in the emergency department. An 18-month-old girl presents with two hours of sudden drooling, refusal to feed and an intermittent cough. She was found next to her sibling's toy, which has an open battery compartment and a missing 20 mm lithium coin cell. She is alert and pink, is not stridulous, and her observations are stable. The team asks you to establish the diagnosis and the immediate plan, then proceed to imaging, the pre-removal measure, the definitive step, and the family counselling. You have 12 minutes with the team and 5 minutes for examiner discussion. ^[1]