Fatal aortoesophageal fistula secondary to button battery ingestion in a young child

We present a case of fatal aortoesophageal fistula in a 14 month old girl. She presented to theemergency department with acute hematemesis. A foreign body in the esophagus was identified onchest X-ray. Despite intensive resuscitation, she went into cardiac arrest and died. In the three weeksprior to death, she had non-specific symptoms; based on an elevated urinary polymorph level andEscherichia coli culture, she was diagnosed with a urinary tract infection and prescribed antibiotics.Postmortem imaging revealed a metallic foreign body in the esophagus consistent with a buttonbattery and autopsy revealed an aortoesophageal fistula caused by a 20 mm imprint code CR 2025button battery. It is unclear how long the battery had been in situ. We highlight the importance of ahigh index of suspicion for battery ingestion in children, the need for clinicians to recognize a buttonbattery on radiography, and the value of routine postmortem imaging in the detection of findings thatmay be relevant to the autopsy. Although rare, fatal cases due to button battery ingestion arepreventable.
Source: Journal of Forensic Radiology and Imaging - Category: Radiology Source Type: research