A Fatal Case of Coin Battery Ingestion in an 18-Month-Old Child: Case Report and Literature Review. 2017

Francesco Ventura, and Sara Candosin, and Rosario Barranco, and Alessandro Bonsignore, and Luisa Andrello, and Luca Tajana, and Antonio Osculati
From the *Department of Legal and Forensic Medicine, University of Genova, Genova, Italy; †Legal Medicine Service, Canton of Ticino, Switzerland; and ‡Department of Public Health, Forensic and Experimental Medicine, University of Pavia, Pavia, Italy.

The ingestion of extraneous substances is quite common in clinical practice; it usually befalls in the pediatric age, mostly between 6 months and 6 years. In most cases, complications do not emerge, and the prognosis is considered favorable. However, when a case of battery ingestion occurs, serious adverse events may develop. The ingestion of these components is a potential life-threatening event for children.In this article, we report the case of an 18-month-old child who died from hemorrhagic shock due to an aortoesophageal fistula caused by a 20 mm lithium button battery lodged in the esophagus.The child presented vomiting blood, and laboratory results revealed a severe anemization, which later led to death.The autopsy showed a coin battery located in the middle third of the esophagus as well as a transmural erosion of the esophageal wall with fistulization into the aortic wall. The histological examination revealed a severe necrosis of the esophageal and aortic walls in line with the junction between the aortic arch and the descending part.

UI MeSH Term Description Entries
D007223 Infant A child between 1 and 23 months of age. Infants
D009336 Necrosis The death of cells in an organ or tissue due to disease, injury or failure of the blood supply.
D011211 Electric Power Supplies Devices that control the supply of electric current for running electrical equipment. Power Sources,Power Supplies,Electric Power Sources,Power Sources, Electric,Power Supplies, Electric,Electric Power Source,Electric Power Supply,Power Source,Power Source, Electric,Power Supply,Power Supply, Electric,Supply, Electric Power
D004937 Esophageal Fistula Abnormal passage communicating with the ESOPHAGUS. The most common type is TRACHEOESOPHAGEAL FISTULA between the esophagus and the TRACHEA. Esophageal Fistulas,Fistula, Esophageal,Fistulas, Esophageal
D004947 Esophagus The muscular membranous segment between the PHARYNX and the STOMACH in the UPPER GASTROINTESTINAL TRACT.
D005260 Female Females
D005547 Foreign Bodies Inanimate objects that become enclosed in the body. Foreign Objects,Gossypiboma,Retained Surgical Instruments,Retained Surgical Items,Retained Surgical Needle,Retained Surgical Sponge,Retained Surgical Tools,Textiloma,Bodies, Foreign,Body, Foreign,Foreign Body,Foreign Object,Gossypibomas,Object, Foreign,Objects, Foreign,Retained Surgical Instrument,Retained Surgical Item,Retained Surgical Needles,Retained Surgical Sponges,Retained Surgical Tool,Surgical Instrument, Retained,Surgical Instruments, Retained,Surgical Item, Retained,Surgical Items, Retained,Surgical Needle, Retained,Surgical Needles, Retained,Surgical Sponge, Retained,Surgical Sponges, Retained,Surgical Tool, Retained,Surgical Tools, Retained,Textilomas
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001018 Aortic Diseases Pathological processes involving any part of the AORTA. Aortic Disease,Disease, Aortic,Diseases, Aortic
D012771 Shock, Hemorrhagic Acute hemorrhage or excessive fluid loss resulting in HYPOVOLEMIA. Hemorrhagic Shock

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