A two-year-old toddler arrived at the emergency room at Hadassah Ein Kerem Hospital this week, vomiting and choking nonstop, accompanied by worried and clueless parents, who found themselves dealing with difficult moments of anxiety and a race against time.
What began as a routine, quiet evening at the family home quickly turned into a complex medical event, which ended with surgery to save him, thanks to the rapid response of the medical teams and professional and precise treatment at Hadassah Ein Kerem Hospital by pediatric gastroenterology specialists.
""It was a completely normal evening, during which we were all at home with the family," says the toddler's mother. "When dinner time came, we fed him, and he started vomiting and choking, and we were very scared.".
According to her, nothing hinted at the approaching danger. The family members were living their normal lives at home, until suddenly the child began to show clear and worrying signs of distress.
She says her son began feeling sick shortly after eating chocolate with his older brother. At first, the parents thought it was a passing reaction or a momentary difficulty swallowing, but when the vomiting continued and the child had difficulty calming down, they realized that this was a condition that required immediate medical examination.
The parents quickly took their son to the emergency room at Hadassah Ein Kerem Hospital, where the medical team began immediately assessing his condition.
A review of the medical file revealed that a year ago, when he was one year old, he swallowed a caustic substance and was rushed to the pediatric emergency room at Hadassah Ein Kerem. Even then, his life was saved by the staff. According to the doctors, this is a caustic chemical substance that can cause burns and damage to body tissues such as the skin, eyes, mouth, and digestive tract. Exposure to the same substance through contact, ingestion, or inhalation can be dangerous.
Given the toddler's medical history, and in light of the previous incident that occurred a year earlier, the doctors were required to consider various possibilities and understand what was behind the sudden deterioration.
""When he arrived and we were told by the family that he had eaten chocolate and had reached this state, we were very surprised," says Dr. Zeev Davidovich, a pediatric gastroenterologist at Hadassah who led the toddler's treatment. "We tried to understand if there was a connection to the substance he swallowed a year ago, but all the tests came back with normal results.".
Despite the normal test results, the child's condition did not improve. Even when they tried to feed the toddler again, he continued to vomit. At this point, it was clear to the team that this was a more significant problem, and that there was a real difficulty in the passage of food through the esophagus or upper digestive tract.
The doctors quickly proceeded with a thorough investigation, gathering additional details from the family members and reexamining the sequence of events. As the picture became clearer, suspicion arose that the source of the problem was not in the chocolate itself, but in another ingredient hidden within it.
After a thorough examination, it turned out that the child had eaten chocolate consisting of several layers and containing a nut. "His older brother, who is six years old, ate chocolate," says the mother, "We didn't know what kind. Only later did it turn out that it was the round chocolate with a whole nut inside, which he gave to his little brother.".
The new information immediately changed the direction of medical thinking. The medical team realized that it was most likely a foreign body that had become lodged in the esophagus – a nut that had been inside the chocolate and had caused a dangerous blockage. For a young toddler, every minute was critical. Such a situation could quickly lead to difficulty swallowing, vomiting, pain and even more serious complications if not treated in time.
As they concluded, it turned out that a nut was stuck in the toddler's esophagus.
""We went straight to the operating room. Removing a nut from the esophagus is a complex task and it is very urgent," explains Dr. Davidovich. "The procedure is very delicate and we must take care not to cause irreversible damage to the esophagus." The specialist explains that the decision was made quickly and that removing a foreign body from the esophagus of a young child requires high skill, great precision, and the combined work of several medical teams, due to the high sensitivity of the area and the fear of tissue damage.
In the surgery, which also involved Dr. Haytam Mesmer and Dr. Baltus Govti from the Anesthesiology Department at Hadassah Ein Kerem, the team acted professionally and calmly, making an effort to remove the nut intact and prevent any further damage.
The surgery was successful, and the child's life was saved, with no harm done. For the family, the hours of anxiety were replaced by a sense of immense relief.
""I always recommend checking the instructions written on the packaging," concludes Dr. Davidovich, emphasizing that the case once again highlights the great importance of supervising young children while eating, especially when it comes to foods containing nuts, hard candies, or foods that may cause choking or blockage. Sometimes, a small, innocent-looking product can become life-threatening in an instant.
