A 14-month-old male was seen at an outside hospital on a Saturday in late April for a choking episode. An X-ray (see Figure 1) was done, and physicians there thought the round metallic foreign body was a coin and asked the family to return in 24 hours. The patient was seen again on Sunday. Another chest X-ray (anteroposterior only) was done, and the esophageal coin was seen again. Because it had not moved, the patient was transferred to our hospital. On arrival, we looked at the X-ray and saw that the foreign body was clearly a battery.
Explore This IssueACEP Now: Vol 33 – No 09 – September 2014
Surgery was called, and the patient was taken to the operating room. An initial swallow study done the day after retrieval appeared normal. The patient did well but returned two weeks later with coughing and aspiration and had developed a tracheoesophageal fistula (see Figure 2). Visit www.ACEPNow.com for a video of this case.
Case, photos, and video submitted by Cindy Nielsen, MD, The Children’s Hospital at OU Medical Center in Oklahoma City.
Dr. Fox is associate professor of adult and pediatric emergency medicine at Carolinas Medical Center in Charlotte, North Carolina.
- Sharpe SJS, Rochette LM, Smith GA. Pediatric battery-related emergency department visits in the United States, 1990-2009. Pediatrics. 2012;129:1111-7.
- National Capital Poison Center. Mechanisms of battery-induced injury. National Capital Poison Center Web site. Available at: http://www.poison.org/battery/mechanism.asp. Accessed June 12, 2014.
- Litovitz T1, Whitaker N, Clark L, et al. Emerging battery-ingestion hazard: clinical implications. Pediatrics. 2010;125:1168-77.