Button battery induced traumatic tracheoesophageal fistula: Case report and review of literature.

Although accidental ingestions by children of various household chemicals and medicines are well described and the treatment is supported by protocols and hotlines, the ingestion of button batteries is less publicized, and the dangers are less understood by both parents and health care providers. We describe the case of a three-year-old girl, who presented to hospital with respiratory distress, cough, and fever; three weeks after the ingestion of a button battery. Endoscopic examination revealed impacted 20 mm disc battery, which was removed, and a tracheoesophageal fistula (TOF) in the upper third of the oesophagus associated with severe oesophagitis, and oesophageal ulcers. There was also evidence of oesophageal fungal infection, and severe hyperemic pan-gastritis and duodenitis. Parents were counseled and conservative management advised, but they opted for surgical repair of the TOF. The operation was done and the child survived, but she ended up with a tracheal stricture and recurrent chest infections. In conclusion, oesophageal button battery impaction places the patient at high risk for tracheoesophageal fistula. The key to successful therapy is prompt diagnosis and removal, which saves life and decreases morbidity. Because of the complications associated with this condition, patients should be managed at an institution with skilled personnel and facilities for advanced life support.