Stiff Neck and Drooling in a Young Girl

William B Prince1, Richard M Cantor2,3

  • 1From the Emergency Medicine/Pediatrics.

Insights

A child swallowed a button battery, initially sent home, but later presented with neck pain and secretions. Imaging revealed the esophageal button battery and surrounding air, indicating a serious complication.

Area of Science:

  • Pediatric Emergency Medicine
  • Otolaryngology
  • Radiology

Background:

  • Button battery ingestion is a common pediatric emergency.
  • Esophageal button battery impaction can lead to severe complications if not promptly identified and managed.

Observation:

  • A 3-year-old girl presented with neck pain and pooling of secretions 4 days after a choking episode.
  • Initial evaluation at another emergency department, including a chest X-ray, was normal, and the child was discharged.
  • The patient was later diagnosed with pharyngitis and treated with amoxicillin.

Findings:

  • A soft tissue neck X-ray revealed a 20-mm button battery lodged in the esophagus.
  • Air lucencies in the prevertebral soft tissues indicated esophageal perforation or significant inflammation.

Implications:

  • Delayed diagnosis of esophageal button battery impaction can lead to life-threatening complications such as perforation.
  • This case highlights the importance of thorough evaluation and follow-up for suspected button battery ingestion, even with initially normal imaging.
  • Prompt recognition and intervention are crucial for managing pediatric esophageal button battery foreign bodies.

Related Concept Videos

Muscles of the Anterior Neck01:26

Muscles of the Anterior Neck

The anterior neck muscles are the group of muscles covering the front part of the neck. These muscles are classified into three subgroups. The first one is the superficial muscles, the most visible muscles in the front of the neck. It includes the platysma and sternocleidomastoid. The second group is the suprahyoid muscles, located above the hyoid bone. This group comprises the digastric, mylohyoid, geniohyoid, and stylohyoid. Lastly, the infrahyoid muscles are found below the hyoid bone and...
4.9K
Arteries of the Head and Neck01:26

Arteries of the Head and Neck

The human body's intricate network of arteries ensures that every organ system receives the necessary oxygen and nutrients for optimal function. The arterial network in the head and neck region is particularly complex, providing vital blood flow to the brain, eyes, and other critical structures. Prominent arteries in this region include the internal carotid arteries and the vertebral arteries.
The internal carotid arteries supply blood to the anterior portion of the cerebrum. They enter the...
3.6K
Veins of Head and Neck01:19

Veins of Head and Neck

The blood drainage from the head and neck is primarily managed by three pairs of veins: the external jugular, internal jugular, and vertebral veins. The external jugular veins drain superficial scalp and face structures, passing over the sternocleidomastoid muscles to empty into the subclavian veins.
On the other hand, the vertebral veins, unlike their arterial counterparts, are not primarily responsible for brain drainage. Instead, they drain the cervical vertebrae, spinal cord, and some small...
5.8K
Bullying02:04

Bullying

A modern form of aggression is bullying. As you learn in your study of child development, socializing and playing with other children is beneficial for children’s psychological development. However, as you may have experienced as a child, not all play behavior has positive outcomes. Some children are aggressive and want to play roughly. Other children are selfish and do not want to share toys. One form of negative social interactions among children that has become a national concern is...
8.9K
Stereotype Threat and Self-fulfilling Prophecies02:09

Stereotype Threat and Self-fulfilling Prophecies

When we hold a stereotype about a person, we have expectations that he or she will fulfill that stereotype. A self-fulfilling prophecy is an expectation held by a person that alters his or her behavior in a way that tends to make it true. When we hold stereotypes about a person, we tend to treat the person according to our expectations. This treatment can influence the person to act according to our stereotypic expectations, thus confirming our stereotypic beliefs. Research by Rosenthal and...
42.5K
Social Exchange Theory02:06

Social Exchange Theory

We have discussed why we form relationships, what attracts us to others, and different types of love. But what determines whether we are satisfied with and stay in a relationship? One theory that provides an explanation is social exchange theory. According to social exchange theory, we act as naïve economists in keeping a tally of the ratio of costs and benefits of forming and maintaining a relationship with others (Rusbult & Van Lange, 2003).
40.8K