Impacted button battery causing acquired tracheoesophageal fistula in a 2-month-old infant

Abstract

A 2-month-old male infant was brought with fever and respiratory distress of 5-days duration. Investigations showed a round, radiopaque foreign body in the upper esophagus. The child was diagnosed to have coin ingestion and referred to our center for removal of the same. Careful review of the X-rays led us suspect button battery ingestion. Emergency rigid esophagoscopy and foreign body removal was performed under general endotracheal anesthesia. A rusted, 4 mm wide button battery was removed using optical forceps with difficulty. Postoperatively, the child was managed on a ventilator. He received supportive care. Check scopy done using ultrathin, flexible esophagoscope on day 10 showed acquired tracheoesophageal fistula. The child underwent defunctioning gastrostomy and feeding jejunostomy, but succumbed to sepsis from mediastinitis and recurrent pneumonitis 2 days later. Ingestion and impaction of the button battery in a 2-month-old infant are extremely rare and unreported in literature. Hence, the case report.