Oesophageal and gastrointestinal foreign-body ingestion — branching viva

A branching viva following one toddler after a suspected button-battery ingestion, from the doorway radiograph through emergency endoscopy timing, the honey demulcent adjunct and its contraindications, recognition of delayed aorto-oesophageal fistula, and the contrast with an asymptomatic gastric coin and a multiple-magnet ingestion.

branching clinical structured oral6 min readVerification in progress

Prompt

A three-year-old is brought to a regional emergency department after a suspected battery ingestion. The examiner releases information in stages. The candidate must interpret the radiograph, apply the NASPGHAN and ESPGHAN urgency tiers, decide on a temporising adjunct when endoscopy is delayed, recognise a delayed complication after removal, and contrast the management of an asymptomatic gastric coin and a multiple-magnet ingestion.

Branching cross-examination

Name: Oesophageal and gastrointestinal foreign-body ingestion — branching viva
Creator: MedVellum
Published: 2026-07-17

This is a MedVellum formative viva. It is not an official RACP, MRCPCH, ABP, ACGME or RCPSC station, mark scheme, duration or pass standard. Release each update only after the candidate states the diagnosis, the urgency tier, and the immediate action. [1] [3]

Candidate brief

You are the senior paediatric clinician in a regional emergency department. Speak as you would at the bedside. State the urgency tier and the time target for each decision, name the object confidently from the radiograph, and apply the NASPGHAN and ESPGHAN urgency categories. This is one continuous case with three branches. [3]

Paediatrics Fellowship Pro

You have read the opening of this viva. The complete unit — every section and its primary-source references — is part of the Paediatrics Fellowship fellowship atlas.

References5Show ledger

[1]Kramer RE, Lerner DG, Lin T, et al. Management of ingested foreign bodies in children: a clinical report of the NASPGHAN Endoscopy Committee Journal of pediatric gastroenterology and nutrition, 2015.PMID 25611037
[3]Mubarak A, Benninga MA, Broekaert I, et al. Diagnosis, Management, and Prevention of Button Battery Ingestion in Childhood: A European Society for Paediatric Gastroenterology Hepatology and Nutrition Position Paper Journal of pediatric gastroenterology and nutrition, 2021.PMID 33555169
[5]Tran C, Nunez C, Eslick GD, et al. Complications of button battery ingestion or insertion in children: a systematic review and pooled analysis of individual patient-level data World journal of pediatrics, 2024.PMID 39168931
[6]Quitadamo P, Gragnaniello P, Isoldi S, et al. Magnetic foreign body ingestion in pediatric age Digestive and liver disease, 2024.PMID 37985250
[10]Whelan R, Shaffer A, Dohar JE Button battery versus stacked coin ingestion: A conundrum for radiographic diagnosis International journal of pediatric otorhinolaryngology, 2019.PMID 31404782