Differential Diagnosis for a 12-Month-Old Who Ate a Small Piece of Wax

• Single Most Likely Diagnosis:
  • Gastrointestinal Irritation: This is the most likely outcome due to the ingestion of a foreign substance. The wax could cause mild stomach upset, but it is generally not toxic and should pass through the digestive system without major issues.
• Other Likely Diagnoses:
  • Intestinal Blockage: Although less likely due to the small size of the wax piece, there's still a possibility that it could cause a blockage, especially if the child has a narrow intestinal passage or if the wax accumulates with other substances.
  • Choking: If the wax was not fully swallowed and got stuck in the throat, it could lead to choking. However, since the question implies ingestion, this is less likely.
• Do Not Miss Diagnoses:
  • Intestinal Perforation: While rare, if the wax is sharp or if there's an underlying condition, it could potentially perforate the intestine, leading to severe infection and requiring immediate medical attention.
  • Allergic Reaction: If the wax contains certain chemicals or dyes, there's a small chance the child could have an allergic reaction, which could range from mild to severe.
• Rare Diagnoses:
  • Wax Poisoning: Certain types of wax, especially those containing toxic substances like lead or other heavy metals, could potentially cause poisoning. However, this is rare and more likely with repeated exposure or ingestion of large quantities.
  • Obstruction of the Appendix: In very rare cases, a small object like a piece of wax could potentially obstruct the appendix, leading to appendicitis. This is extremely unlikely but could be considered in the differential diagnosis due to the severity of appendicitis.