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Spondylodiscitis following ingestion of button battery in an infant-a case-based update
Fardad T Afshari1, Oliver Gee2, William B Lo3
1Department of Neurosurgery, Birmingham Children's Hospital, Steelhouse Lane, Birmingham, B4 6NH, UK. afsharifardad@googlemail.com.
Insights
Button battery ingestion in infants can cause rare spinal infections like discitis and osteomyelitis. Early spinal imaging is crucial for timely diagnosis and treatment of these serious complications.
Area of Science:
- Pediatric Surgery
- Pediatric Infectious Diseases
- Pediatric Radiology
Background:
- Button battery ingestion is a growing emergency in infants, potentially causing severe esophageal damage and death.
- A rare but serious complication is the development of discitis and osteomyelitis in the cervical and upper thoracic spine.
- Diagnosis is often delayed due to non-specific symptoms and initial focus on acute airway and esophageal issues.
Purpose of the Study:
- To report a case of infant button battery ingestion complicated by spinal osteomyelitis.
- To emphasize the importance of thorough spinal evaluation in affected children.
Main Methods:
- Case report of a 1-year-old girl with button battery ingestion presenting with hematemesis and esophageal injury.
- CT scan revealed vertebral erosion in the cervicothoracic spine.
- MRI confirmed spondylodiscitis (C7-T2) with vertebral erosion and collapse.
Main Results:
- The patient presented with hematemesis and esophageal injury due to button battery ingestion.
- CT imaging showed suspicious vertebral erosion; MRI confirmed C7-T2 spondylodiscitis with vertebral collapse.
- The child recovered after a prolonged course of antibiotics.
Conclusions:
- Button battery ingestion can lead to rare but severe spinal complications like osteomyelitis.
- Prompt clinical and radiological spinal assessment is vital to prevent delayed diagnosis and manage complications effectively.
Abstract:
Button battery ingestion in infants is an increasingly common surgical emergency which can lead to oesophageal perforation, mediastinitis, trachea-oesophageal fistulation, airway compromise and death. One exceedingly rare complication of battery ingestion is discitis and osteomyelitis in the cervical and upper thoracic spine. Diagnosis is normally delayed due to the non-specific presentation, delayed imaging findings and the initial clinical focus on dealing with the immediate, and potentially life-threatening, complications. We describe a case of a 1-year-old girl who presented with haematemesis and an oesophageal injury, secondary to button battery ingestion. Sagittal reconstruction of the CT chest demonstrated a suspicious area of vertebral erosion in the cervicothoracic spine which prompted a further evaluation with MRI demonstrating spondylodiscitis of C7-T2 with vertebral erosion and collapse. The child was successfully treated with long course of antibiotics. We wish to highlight the importance of clinical and radiological spinal assessment in children with button battery ingestion to avoid delayed diagnosis and complications of spinal osteomyelitis.
