Sudden death following accidental ingestion of a button battery by a 17-month-old child: a case study

Abstract

Cases of ingesting button batteries by children are not common clinical situations in forensic medicine. Although it can be a cause of death when associated with digestive perforations, no cases of sudden death have been reported in the literature. We report the case of a 17-month-old girl who presented at home with haematemesis, followed by failed cardiopulmonary resuscitation. The child had been treated on two occasions for nasopharyngitis, 14 and 18 days prior to her death. The post-mortem scan revealed a radio-opaque foreign body in the oesophagus. The autopsy revealed the presence of a round button battery, 20 mm in diameter, blocking the lumen of the oesophagus in its upper third, associated with two parietal oesophageal ruptures opposite each other. There was limited digestive haemorrhage, but above all significant bronchial inhalation of blood. Toxicology analyses showed slightly increased blood levels of the heavy metals of which the battery was composed (lithium, chromium, manganese and molybdenum). The anatomopathological analyses confirmed the recent nature of these ruptures. Ingestions of button batteries localised at the level of the oesophagus are the cases linking to the highest risk of complications, particularly for batteries with a diameter of more than 20 mm and in children under the age of 4. The main difficulty in such clinical situations is identifying when the ingestion occurred, as more often than not, no witnesses are present. We discuss the advantages of anatomopathology and toxicology examinations targeted towards heavy metals in these forensic situations.

Chronic stridor in a toddler after ingestion of a discharged button battery: a case report

“…The boy survived but required thoracotomy for removal [24]. Several publications of prolonged BBI report fatalities due to trachea-esophageal fistulation or sudden hemorrhage after vasculo-esophageal fistulation [3,[25][26][27][28].…”

A Rare Incidence of Neonatal Button Battery Ingestion: A Case of Child Abuse and Neglect

“…It is of the utmost significance, in particular in situations in which the child does not respond to treatment for respiratory infections. To reduce the likelihood of complications and to improve the likelihood of a positive outcome, it is of the utmost importance to take a multidisciplinary team approach, make an early referral to a pediatric/ENT surgeon, and provide care that is both swift and synchronized [ 20 , 21 ].…”

Consumer product ingestion and aspiration in children: A 15‐year review

“…This increase likely reflects societal trends in battery prevalence and should serve to raise alarm of this potentially deadly injury. In Guinet et al's case of battery ingestion and subsequent death of a 17‐month‐old child, an indolent nature of injury progression demonstrates the importance of physician awareness and recognition of this pediatric ingestion . Additionally, their analysis highlights battery size and shape as significant risk factors for esophageal damage, particularly disk batteries > 20 mm.…”

“…In Guinet et al's case of battery ingestion and subsequent death of a 17-month-old child, an indolent nature of injury progression demonstrates the importance of physician awareness and recognition of this pediatric ingestion. 43 Additionally, their analysis highlights battery size and shape as significant risk factors for esophageal damage, particularly disk batteries > 20 mm. Interestingly, Laulicht et al's analysis demonstrates an ability to curtail the damaging electrochemical esophageal sequela of battery ingestion by the addition of a synthetic indigestible coating, a possible diminution to an increasingly common injury.…”