Trachea-o-esophageal Fistula following Button Battery Ingestion, Presenting One Month after the Event- A Rare Presentation

Abstract

Trachea-o-oesophageal fistula (TEF) formation after battery ingestion is a fatal complication with severe consequences. Urgent removal of battery is necessary within few hours. Persistent oral intolerance, respiratory difficulty or clinical deterioration after removal of battery should raise a suspicion of oesophageal rupture/leak or TEF. We present case of a 3-year-old who ingested button battery, which was diagnosed immediately but due to delay in referral to the concerned specialty the battery was removed on the 2nd day followed by large oesophageal rupture. However initially the child improved after the repair, the development of TEF was presented much later which was a rare presentation. A large fistula which was not closed by conservative approach was successfully closed surgically. The child was recovered after the repair, and the confirmation of adequate repair by esophagoscopy was done. Button battery ingestion (BBI) should be considered a surgical emergency, requiring urgent removal and vigilant monitoring.