# A Case of Unwitnessed Ingestion: Highlighting the Diagnostic Challenge in High-Risk Patients

## TL;DR

A three-year-old boy's case highlights the challenge of diagnosing foreign body ingestion in children with communication difficulties.

## Contribution

The case emphasizes the importance of high suspicion for foreign body ingestion in children with a history of non-food item consumption.

## Key findings

- A three-year-old boy ingested a 20 mm button battery, requiring emergency endoscopic removal.
- Black stool was a key clinical finding despite otherwise normal assessment.
- The case underscores the need for vigilance in high-risk pediatric patients.

## Abstract

In the paediatric emergency medicine setting, the ingestion of foreign bodies is an important topic due to its ability to rapidly progress to a life-threatening emergency and the often difficult history-taking of the paediatric population. It is also a relatively common presentation, largely managed conservatively; however, it can also necessitate immediate invasive intervention. In this case, we explore the management of a three-year-old boy who presented with black stool but otherwise a normal assessment, who was subsequently found to have ingested a 20 mm button battery requiring emergency endoscopic removal. The main lesson from this case is to have a high index of suspicion for ingested foreign bodies in children with communication difficulties and a history of non-food item ingestion; this applies to both clinicians and parents.