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Delayed presentation of button battery ingestion: a devastating complication

Robert Chessman1, Misha Verkerk2, Richard Hewitt3

  • 1Department of ENT, St George's Hospital London, London, UK.

BMJ Case Reports
|April 8, 2017
PubMed

Insights

A child

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Emergency Medicine

Background:

  • Button battery ingestion in children poses a significant diagnostic challenge.
  • Delayed diagnosis can lead to severe esophageal injury and complications.

Observation:

  • A 12-month-old presented with respiratory symptoms initially misdiagnosed as bronchiolitis.
  • Worsening symptoms led to emergency department re-evaluation, revealing an upper esophageal button battery.

Findings:

  • Esophagoscopy confirmed a 20 mm button battery and a tracheoesophageal fistula.
  • Surgical intervention included near-total esophagectomy, cervical esophagostomy, gastrostomy, and tracheal repair with a stent.

Implications:

  • This case underscores the critical need for high suspicion of foreign body ingestion, especially button batteries, in children with unexplained respiratory or gastrointestinal symptoms.
  • Prompt diagnosis and management are vital to prevent life-threatening complications like mediastinitis and tracheoesophageal fistulas.

Keywords:
GastroenterologyOesophagusOtolaryngology

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