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...

Full description

Bibliographic Details
Main Authors: Antonino Granata, Caterina Gandolfo, Carlo Acierno, Marcello Piazza, Gaetano Burgio, Mario Traina
Format: Article
Language:English
Published: BMC 2018-10-01
Series:Journal of Medical Case Reports
Subjects:
Online Access:http://link.springer.com/article/10.1186/s13256-018-1818-5
id doaj-c18a8bb1376d42d59bdca77a241bf449
record_format Article
spelling 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
work_keys_str_mv AT antoninogranata buttonbatteryremovedfromthestomachresultinginamissedaortoesophagealfistulaamultidisciplinaryapproachtorescuingaveryyoungpatientacasereport
AT caterinagandolfo buttonbatteryremovedfromthestomachresultinginamissedaortoesophagealfistulaamultidisciplinaryapproachtorescuingaveryyoungpatientacasereport
AT carloacierno buttonbatteryremovedfromthestomachresultinginamissedaortoesophagealfistulaamultidisciplinaryapproachtorescuingaveryyoungpatientacasereport
AT marcellopiazza buttonbatteryremovedfromthestomachresultinginamissedaortoesophagealfistulaamultidisciplinaryapproachtorescuingaveryyoungpatientacasereport
AT gaetanoburgio buttonbatteryremovedfromthestomachresultinginamissedaortoesophagealfistulaamultidisciplinaryapproachtorescuingaveryyoungpatientacasereport
AT mariotraina buttonbatteryremovedfromthestomachresultinginamissedaortoesophagealfistulaamultidisciplinaryapproachtorescuingaveryyoungpatientacasereport
_version_ 1725152390221398016