Aspiration pneumonia and esophagotracheal fistula secondary to button battery ingestion

Abstract

We report a case of acute bronchopneumonia and esophagotracheal fistula caused by a swallowed button battery in a 3-year-old girl. It was unclear exactly how long the battery had been trapped in the esophagus. The patient had undergone a tonsillectomy and adenoidectomy 3 weeks before the battery was finally exposed on an X-ray film. She refused to eat solid food after the surgery and stopped eating completely 10 days later. Three weeks after surgery, she presented to the Emergency Department with vomiting and acute respiratory distress, experienced cardiopulmonary arrest in the intensive care unit and could not be resuscitated. Postmortem examination revealed severe acute bronchopneumonia and massive blood aspiration due to an esophagotracheal fistula secondary to a button battery lodged in the esophagus. This case highlights the importance of including a swallowed button battery in the differential diagnosis of a toddler with dysphagia and anorexia.

Metallic Foreign Body Ingestion During Childhood; the Experience of a University Hospital in Turkey

“…Most of the ingested MFBs are caught by the esophagus, the narrowest section outside the appendix of GIS (6,7). Consistent with previous studies, most MFBs were located in the esophagus in our cases (11)(12)(13)(14)(15).…”

“…Symptoms vary depending on the location and type of MFBs, age, and complications (6)(7)(8)(9)(10)(11). Feeding difficulty may be the only symptom in infants, whereas symptoms such as vomiting, dysphagia, and chest pain are seen in older age children (11).…”

“…These publications are either case reports based on developed complications or a listing of all foreign bodies (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13). The ingestion of foreign bodies mostly occurs under the age of 5; during this period, children have the instinct of putting anything in the mouth, and incompletely developed functions of eating and chewing result in ingestion.…”

Disk Battery Ingestion A Malpractice Case that Results in Pneumonia

“…Disk battery ingestion is also an unusual cause of pneumonia in pediatric population (15,16). The chemical effects of battery or tracheoesophageal fistula may help occurrence of pneumonia as seen in our case.…”

The impact of 2011!

“…Case reports covered a very wide range of topics including lethal necrotizing fasciitis [29], Ehrlichiosis [30], Armanni-Ebstein phenomenon related to starvation [31], and Takotsubo cardiomyopathy [32]. Traumatic deaths resulted from drowning in paraffin wax [33] and an impacted button battery with a tracheoesophageal fistula [34]. Other sections such as Images in Forensics and Differential Diagnosis have also attracted interesting case studies and vignettes that have ranged from veterinary [35] to human forensic pathology [36].…”