Fatal aortoesophageal fistula caused by coin battery ingestion in a 18-month-old girl: a case report. We report a case of a 18-month-old girl who died from a massive bleeding due to an aortoesophageal fistula caused by a 20-mm lithium button battery lodged in the oesophagus. A 18-month-old girl was brought to a paediatric emergency department because, shortly before presentation, the parents saw her vomiting blood after being fed some milk. When she arrived at the hospital, the girl was awake and alert and appeared uncomfortable in her mother’s lap; clinical examination showed tachycardia and laboratory results revealed a severe anaemization (haemoglobin was 7.6 g/dl). Within few hours after admission, the girl’s clinical condition deteriorated, she developed haematemesis and collapsed. Despite intensive resuscitation, the patient remained unresponsive, and death was declared 3 hours after. During the autopsy, we found a CR 2032 coin type battery (3 Volt lithium manganese dioxide battery, diameter 20 mm) located in the middle third of the oesophagus. The oesophageal wall had transmural erosion with fistulization into the aortic wall, between aortic arch and descending aorta. At visual inspection, the battery showed signs of corrosion with defects on its surface. Approximately 250 mL of blood was found in the stomach and all the bowel until the ileo-cecal valve was full of blood. Piceous stool was found in the remaining bowel, whereas we saw normochromic stools in the rectal ampulla. Histological examinations revealed severe necrosis of both oesophageal and aortic wall; a Scanning Electron Microscope examination confirmed this characteristic and showed there was leakage from the battery.
Fatal aortoesophageal fistula caused by coin battery ingestion in a 18-month-old girl: a case report.
Basso P.;CONGIU, TERENZIO;REGUZZONI, MARCELLA;OSCULATI, ANTONIO MARCO MARIA
2011-01-01
Abstract
Fatal aortoesophageal fistula caused by coin battery ingestion in a 18-month-old girl: a case report. We report a case of a 18-month-old girl who died from a massive bleeding due to an aortoesophageal fistula caused by a 20-mm lithium button battery lodged in the oesophagus. A 18-month-old girl was brought to a paediatric emergency department because, shortly before presentation, the parents saw her vomiting blood after being fed some milk. When she arrived at the hospital, the girl was awake and alert and appeared uncomfortable in her mother’s lap; clinical examination showed tachycardia and laboratory results revealed a severe anaemization (haemoglobin was 7.6 g/dl). Within few hours after admission, the girl’s clinical condition deteriorated, she developed haematemesis and collapsed. Despite intensive resuscitation, the patient remained unresponsive, and death was declared 3 hours after. During the autopsy, we found a CR 2032 coin type battery (3 Volt lithium manganese dioxide battery, diameter 20 mm) located in the middle third of the oesophagus. The oesophageal wall had transmural erosion with fistulization into the aortic wall, between aortic arch and descending aorta. At visual inspection, the battery showed signs of corrosion with defects on its surface. Approximately 250 mL of blood was found in the stomach and all the bowel until the ileo-cecal valve was full of blood. Piceous stool was found in the remaining bowel, whereas we saw normochromic stools in the rectal ampulla. Histological examinations revealed severe necrosis of both oesophageal and aortic wall; a Scanning Electron Microscope examination confirmed this characteristic and showed there was leakage from the battery.
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