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Published on: September 11, 2018
Severe injuries from coin cell battery ingestions: 2 case reports
Joshua M Hamilton1, Scott A Schraff, David M Notrica
1Phoenix Integrated Surgical Residency, Banner Good Samaritan Hospital, Phoenix, AZ 85006, USA.
Insights
Coin cell battery ingestion can cause severe complications, including fatal aortoesophageal fistula and vocal cord paralysis in children. Increased awareness and prevention are crucial for managing these dangerous incidents.
Area of Science:
- Pediatric Gastroenterology
- Otolaryngology
- Thoracic Surgery
Background:
- Coin cell battery ingestion is typically benign but can lead to severe outcomes.
- Lithium coin cell ingestion poses unique risks due to its electrical potential and corrosive byproducts.
Observation:
- Two young children experienced severe complications from unwitnessed lithium coin cell ingestion.
- One child developed an aortoesophageal fistula, leading to fatal hemorrhage despite surgical intervention.
- The other child suffered bilateral vocal cord paralysis, requiring tracheostomy but showing signs of recovery.
Findings:
- Lithium coin cell ingestion can cause life-threatening aortoesophageal fistula formation.
- Bilateral vocal cord paralysis is a potential complication, necessitating airway support.
- Delayed complications, such as massive bleeding, can occur even after battery removal.
Implications:
- Highlights the critical need for enhanced primary prevention strategies to prevent pediatric coin cell battery ingestion.
- Emphasizes the importance of clinician awareness regarding the diverse and severe presentations of coin cell battery ingestion.
- Underscores the necessity of prompt diagnosis and tailored therapeutic interventions for affected children.
Abstract:
Although coin cell battery ingestion is usually not associated with adverse consequences, case reports have been published that describe serious morbidity and occasional mortality. This report describes 2 young children developing serious complications from unwitnessed Lithium coin cell ingestion. A 19-month-old developed an aortoesophageal fistula from the proximal descending aorta, whereas the other developed bilateral vocal cord paralysis. Massive bleeding from the aortoesophageal fistula occurred 10 days post battery removal, resulting in a fatal outcome despite maximal surgical efforts. The patient with bilateral vocal cord paralysis required tracheostomy for airway stridor but is recovering function. This report adds to the evidence that primary prevention efforts are needed to caution parents about the dangers associated with coin cell batteries, and secondary prevention can be improved by raising awareness among clinicians as to the various clinical presentations and therapeutic options for this condition.
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