Patient Profile
Patient Name
Rohan Desai
Age / Gender
6 Years / Male
Consultant
Dr. Vipulroy Dayanand Rathod
Hospital
Fortis Hospitals Limited, Mulund, Mumbai
Diagnosis
Oesophageal Foreign Body (Impacted Coin)
Past History
No significant past medical history
Patient Background
Master Rohan Desai, a 6-year-old from Thane, Maharashtra, was brought to Fortis Hospital Mulund by his parents after accidentally swallowing a coin while playing at home. Within hours, he began experiencing difficulty swallowing, drooling, and visible discomfort in the chest and throat area. His parents, anxious and unsure whether surgery would be needed, looked for the best Gastroenterologist in Mumbai with experience in emergency endoscopic intervention. Dr. Vipulroy Rathod, Director of Gastroenterology at Fortis Mulund and pioneer of advanced endoscopic procedures in South Asia, assessed the child immediately and proceeded with safe non-surgical retrieval.
Symptoms
Difficulty swallowing — unable to swallow liquids or solids since ingestion
Excessive drooling — pooling of saliva indicating oesophageal obstruction
Chest discomfort — child pointing to mid-sternal area
Refusal to eat or drink — distress on any attempt at swallowing
Mild irritability and crying — consistent with pain and anxiety
Diagnostic Method
Plain X-ray chest and neck
confirmed radio-opaque circular foreign body (coin) impacted at the level of upper oesophagus
Pre-procedure evaluation
nil by mouth status confirmed, fitness for conscious sedation assessed
Clinical assessment
respiratory status, oxygen saturation, and airway patency evaluated and confirmed stable
Diagnostic Method
Master Rohan was diagnosed with an impacted oesophageal foreign body — a coin lodged at the cricopharyngeal level of the upper oesophagus. Coins are among the most commonly ingested foreign bodies in paediatric patients. An impacted coin at this level carries a risk of pressure necrosis, oesophageal perforation, and aspiration if not promptly retrieved. Dr. Rathod determined that immediate endoscopic retrieval was indicated and safe given the child’s stable respiratory status.
Risks if Left Untreated:
Pressure necrosis of oesophageal wall
Oesophageal perforation
Aspiration and respiratory compromise
Mediastinitis in delayed presentations
Treatment Plan
Dr. Vipulroy Rathod performed endoscopic foreign body retrieval under conscious sedation as a planned emergency procedure, avoiding the need for general anaesthesia or surgical intervention.
Why Endoscopic Retrieval Was Chosen Over Surgery
01 - No Surgical Incision
Foreign body retrieved entirely through the mouth using a flexible endoscope. No incision, no wound, no surgical scar.
02 - Safer Than General Anaesthesia
Conscious sedation was sufficient for this procedure, avoiding the risks of general anaesthesia in a young child.
03 - Rapid Resolution
Entire procedure completed in under 20 minutes with immediate symptom relief on retrieval.
04 - Same-Day Discharge
Child was observed for 2 hours post-procedure and discharged the same day in stable condition.
How the Procedure Was Performed
- Pre-procedure preparation — child placed in left lateral position, IV access secured, oxygen saturation monitored throughout.
- Flexible upper GI endoscopy — endoscope passed through the mouth under conscious sedation to visualise the impacted coin in the upper oesophagus.
- Foreign body retrieval — coin grasped using a rat-tooth forceps under direct endoscopic vision and retrieved safely through the mouth.
- Post-retrieval inspection — oesophageal mucosa examined for any pressure injury, laceration, or perforation. Mucosa found intact with no significant injury.
Procedure Summary
- Procedure: Flexible Upper GI Endoscopy with Foreign Body Retrieval
- Foreign Body: Coin (1 Rupee), impacted at upper oesophagus
- Duration: 18 minutes
- Sedation: Conscious sedation
- Post-retrieval Finding: Oesophageal mucosa intact, no perforation
“In paediatric foreign body ingestion, time and precision both matter equally. Rohan’s coin was retrieved endoscopically in under 20 minutes, his oesophagus was intact, and he was eating soft foods within a few hours. This is exactly what endoscopic intervention offers, a safe, fast, scar-free outcome that surgery simply cannot match in these situations.” Dr. Vipulroy Rathod, FASGE | Gastroenterologist in Mumbai | Director, Gastroenterology and Hepatobiliary Sciences, Fortis Hospital Mulund
Post-Procedure Guidelines
Soft and liquid diet for 24 to 48 hours
Observe for any difficulty swallowing, chest pain, or fever and report immediately
No repeat imaging required if child is asymptomatic at discharge
Follow-up with Dr. Vipulroy Rathod if any symptoms persist beyond 48 hours
Parental counselling on foreign body prevention in young children
Outcome
Timepoint | Result |
During Procedure | Coin retrieved successfully, oesophageal mucosa intact |
Immediately Post-Procedure | Child comfortable, swallowing restored, drooling stopped |
2 Hours Post-Procedure | Tolerating liquids well, oxygen saturation normal |
At Discharge | Haemodynamically stable, symptom-free, discharged same day |
48 Hours | Parents reported child eating normally, no complaints |
Long-Term Expectations
With no mucosal injury identified during the procedure, Master Rohan’s prognosis is excellent. No long-term oesophageal complications are anticipated. Parents were counselled on keeping small objects away from young children to prevent recurrence.
Patient Feedback
“We were terrified when Rohan swallowed the coin. We did not know what to expect. Dr. Rathod was so calm and reassuring. Within less than half an hour the coin was out and Rohan was laughing again. We are so grateful we came to Fortis Mulund.” Mrs. Priya Desai, Mother | Thane, Maharashtra