Spondylodiscitis After Ingestion of a Lithium Button Battery: A Case Report.

Abstract

Ingestion of a foreign body is a common problem in the pediatric population. Disc or button batteries represent an important category of foreign body ingestion because of the potential for serious complications if they are not removed promptly. Although the incidence of ingestions involving button batteries has leveled off, the frequency of serious complications from these ingestions has continued to rise1. Orthopaedic sequelae, however, remain rare1. We present the case of a nineteen-month-old girl who developed spondylodiscitis after ingesting a lithium button battery. The patient’s family was informed that data concerning the case would be submitted for publication, and they provided consent. A nineteen-month-old girl presented to the emergency department as a transfer from another hospital after chest radiographs showed a 20-mm disc-shaped foreign body lodged in the esophagus (Figs. 1-A and 1-B). The parents reported that the child had decreased oral intake and increased salivation over the twenty-four hours before presentation. The patient was urgently taken to the operating room and underwent the uncomplicated removal of a lithium button battery under direct visualization with a rigid esophagoscope. During the procedure, it was noted that there was substantial coagulative necrosis around the esophagus and around the foreign body, suggesting that it had been present for a prolonged period of time. The area of necrosis appeared to be less than full thickness in extent. On the first postoperative day, the patient underwent an esophagogram that was consistent with esophageal inflammation; there was no leakage of contrast. She was slowly advanced from a clear liquid diet, as recommended by the National Battery Ingestion Hotline of the National Capital Poison Center, and was discharged to home uneventfully. Fig. 1 Anteroposterior ( Fig. 1-A ) and lateral ( Fig. 1-B ) radiographs at initial presentation showing the button battery lodged in the esophagus. The patient initially …