Tracheoesophageal fistula following button battery ingestion: Successful non-operative management

Abstract The incidence of devastating complications from button battery ingestions is increasing. Battery impactions may result in erosive esophagitis, tracheoesophageal fistula (TEF), esophageal strictures, spondylodiscitis, vocal cord paralysis due to paralysis of recurrent laryngeal nerve(s), and...

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Bibliographic Details
Published in:Journal of pediatric surgery 2013-02, Vol.48 (2), p.441-444
Main Authors: Russell, Robert T, Cohen, Mervyn, Billmire, Deborah F
Format: Article
Language:English
Subjects:
Acquired tracheoesophageal fistula
Button battery
Eating
Esophageal foreign body
Foreign Bodies - complications
Foreign Bodies - therapy
Humans
Infant
Male
Pediatrics
Remission Induction
Surgery
Trachea
Tracheoesophageal Fistula - etiology
Tracheoesophageal Fistula - therapy
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Summary:Abstract The incidence of devastating complications from button battery ingestions is increasing. Battery impactions may result in erosive esophagitis, tracheoesophageal fistula (TEF), esophageal strictures, spondylodiscitis, vocal cord paralysis due to paralysis of recurrent laryngeal nerve(s), and aortoesophageal fistulas with significant morbidity and mortality. We present a case of a 15 month old boy who developed an acquired TEF secondary to ingestion of a 20 mm button battery lodged at the level of the carina. The clinical course and imaging findings are reviewed. Serial limited CT imaging with 3-D reconstruction was helpful in noninvasive assessment of healing and clinical decision making. Of special interest are the negative initial esophagram and the healing of the fistula without the need for surgical intervention.
ISSN:0022-3468
1531-5037
DOI:10.1016/j.jpedsurg.2012.11.040