Button battery removed from the stomach resulting in a missed aortoesophageal fistula – a multidisciplinary approach to rescuing a very young patient: a case report
Abstract Background While coins are still the most common foreign bodies swallowed by children, ingestion of batteries has become more frequent among children due to the increasing access to electronic toys and devices. Coin battery ingestion is potentially life threatening for children. Aortoesopha...
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doaj-c18a8bb1376d42d59bdca77a241bf4492020-11-25T01:15:36ZengBMCJournal of Medical Case Reports1752-19472018-10-011211410.1186/s13256-018-1818-5Button battery removed from the stomach resulting in a missed aortoesophageal fistula – a multidisciplinary approach to rescuing a very young patient: a case reportAntonino Granata0Caterina Gandolfo1Carlo Acierno2Marcello Piazza3Gaetano Burgio4Mario Traina5Endoscopy Service, Department of Diagnostic and Therapeutic Services, IRCCS - ISMETTInterventional Cardiology, Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation, IRCCS - ISMETTPediatric Surgery, ARNAS Civico-Di Cristina-Benfratelli Hospital, Palermo, ItalyDepartment of Anesthesia and Intensive Care, IRCCS – ISMETTDepartment of Anesthesia and Intensive Care, IRCCS – ISMETTEndoscopy Service, Department of Diagnostic and Therapeutic Services, IRCCS - ISMETTAbstract Background While coins are still the most common foreign bodies swallowed by children, ingestion of batteries has become more frequent among children due to the increasing access to electronic toys and devices. Coin battery ingestion is potentially life threatening for children. Aortoesophageal fistula is the most common cause of death in children who have swallowed coin batteries, and there have not been any reported survivors. Case presentation A 3-year-old Caucasian girl presented to the emergency room of a community hospital complaining of abdominal pain. An abdominal X-ray showed a coin lithium battery located in the fundus of her stomach, and she was transferred to a referral pediatric hospital. In the following hours she developed massive hematemesis and severe hypovolemic shock. An emergency laparotomy was attempted, and the coin battery was removed. The initial surgery and multiple blood transfusions did not, however, improve the clinical situation. She was then referred to our tertiary referral center, where a multidisciplinary team decided to attempt a combined angiographic and endoscopic approach to resolve a life-threatening aortoesophageal fistula. A 3-year follow-up was uneventful. Conclusions Coin batteries are designed for a wide variety of small appliances, such as hearing aids, watches, remote controls, and toys. Although a change in the clinical approach to battery ingestion is needed to avoid misdiagnosis or delayed treatment, primary prevention of battery ingestion would be even more effective than an improved treatment.http://link.springer.com/article/10.1186/s13256-018-1818-5Aortic ruptureBalloon-expandable stentsBleedingHemostasisThoracic endovascular aortic repairUrgent procedure |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Antonino Granata Caterina Gandolfo Carlo Acierno Marcello Piazza Gaetano Burgio Mario Traina |
spellingShingle |
Antonino Granata Caterina Gandolfo Carlo Acierno Marcello Piazza Gaetano Burgio Mario Traina Button battery removed from the stomach resulting in a missed aortoesophageal fistula – a multidisciplinary approach to rescuing a very young patient: a case report Journal of Medical Case Reports Aortic rupture Balloon-expandable stents Bleeding Hemostasis Thoracic endovascular aortic repair Urgent procedure |
author_facet |
Antonino Granata Caterina Gandolfo Carlo Acierno Marcello Piazza Gaetano Burgio Mario Traina |
author_sort |
Antonino Granata |
title |
Button battery removed from the stomach resulting in a missed aortoesophageal fistula – a multidisciplinary approach to rescuing a very young patient: a case report |
title_short |
Button battery removed from the stomach resulting in a missed aortoesophageal fistula – a multidisciplinary approach to rescuing a very young patient: a case report |
title_full |
Button battery removed from the stomach resulting in a missed aortoesophageal fistula – a multidisciplinary approach to rescuing a very young patient: a case report |
title_fullStr |
Button battery removed from the stomach resulting in a missed aortoesophageal fistula – a multidisciplinary approach to rescuing a very young patient: a case report |
title_full_unstemmed |
Button battery removed from the stomach resulting in a missed aortoesophageal fistula – a multidisciplinary approach to rescuing a very young patient: a case report |
title_sort |
button battery removed from the stomach resulting in a missed aortoesophageal fistula – a multidisciplinary approach to rescuing a very young patient: a case report |
publisher |
BMC |
series |
Journal of Medical Case Reports |
issn |
1752-1947 |
publishDate |
2018-10-01 |
description |
Abstract Background While coins are still the most common foreign bodies swallowed by children, ingestion of batteries has become more frequent among children due to the increasing access to electronic toys and devices. Coin battery ingestion is potentially life threatening for children. Aortoesophageal fistula is the most common cause of death in children who have swallowed coin batteries, and there have not been any reported survivors. Case presentation A 3-year-old Caucasian girl presented to the emergency room of a community hospital complaining of abdominal pain. An abdominal X-ray showed a coin lithium battery located in the fundus of her stomach, and she was transferred to a referral pediatric hospital. In the following hours she developed massive hematemesis and severe hypovolemic shock. An emergency laparotomy was attempted, and the coin battery was removed. The initial surgery and multiple blood transfusions did not, however, improve the clinical situation. She was then referred to our tertiary referral center, where a multidisciplinary team decided to attempt a combined angiographic and endoscopic approach to resolve a life-threatening aortoesophageal fistula. A 3-year follow-up was uneventful. Conclusions Coin batteries are designed for a wide variety of small appliances, such as hearing aids, watches, remote controls, and toys. Although a change in the clinical approach to battery ingestion is needed to avoid misdiagnosis or delayed treatment, primary prevention of battery ingestion would be even more effective than an improved treatment. |
topic |
Aortic rupture Balloon-expandable stents Bleeding Hemostasis Thoracic endovascular aortic repair Urgent procedure |
url |
http://link.springer.com/article/10.1186/s13256-018-1818-5 |
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