Table 1 Timeline of symptoms and clinical course

0

Symptom onset with coughing, rhinitis similar to a mild respiratory infection

Subsequently, occasionally recurring fever, cough, and rhinitis

/

+ 1 month

Development of mild feeding problems (impaired swallowing, crying when eating) as well as development of an inspiratory stridor

/

Presentation of stridor during routine check-up with resident pediatric

- Prescription of inhalation therapy with Salbutamol

- Referral to ENT for further assessment

+ 2 months

Appointment at ENT

Stable condition, symptoms unchanged

- Visualization of upper laryngo-pharynx without any suspicious findings

- Inability to visualize epiglottis level

- Referral to ENT clinic

Appointment at ENT hospital department

Stable condition, symptoms unchanged

- Endoscopic examination of airway tract up to the epiglottis without any suspicious findings

- Recommendation to continue therapy with inhalatives and corticosteroid suppositories

- Recommendation for bronchoscopy

+ 3 months

Inpatient stay at our pediatric university clinic for further assessment

Stable condition, symptoms unchanged

- Diagnostic bronchoscopy reveals airway obstruction, subsequent esophagoscopy shows unidentifiable FB

- Chest X-ray identifies FB as button battery

- First endoscopic salvage attempt, unsuccessful due to complexly lodged position

- Second endoscopic salvage attempt with ENT colleagues and rigid esophagoscope, successful removal

+ 5 months

Follow-up esophagoscopy in our clinic

Child in good condition but with occasional swallowing difficulties

Visualization of moderate stenosis Bougienage due to feeding difficulties

+ 6,5 months & + 8 months

Follow-up esophagoscopy in our clinic

Child in good, asymptomatic condition, thriving

- Visualization of moderate stenosis

- No bougienage due to asymptomatic child

- biannual controls since