Korean J Radiol.  2008 Dec;9(6):555-558. 10.3348/kjr.2008.9.6.555.

Spondylodiscitis Complicated by the Ingestion of a Button Battery: a Case Report

• Sudhakar P
• Al-Dossary J
• Malik N

• KMID: 1118878
• DOI: http://doi.org/10.3348/kjr.2008.9.6.555

Abstract

A one-and-a-half year old boy who presented with a cough, irritability, and refusal of food was found to have an impacted foreign body in his upper esophagus. We present the radiologic findings of the foreign body (a button battery) impacted in the upper esophagus and its complications; namely, mediastinitis and spondylodiscitis after endoscopic removal. Further, plain radiograph and MR imaging findings are discussed along with literature review.

Keyword

Foreign body; Battery, Infective discitis; Osteomyelitis; Magnetic resonance (MR)

MeSH Terms

Discitis/diagnosis/*etiology
*Esophagus
Foreign Bodies/*complications/radiography
Humans
Infant
Magnetic Resonance Imaging
Male
Mediastinitis/diagnosis/etiology

Figure

• 

  Fig. 1 Spondylodiscitis in a child. A. Plain chest film demonstrates foreign body (button battery) in superior mediastinum. Bilateral chest tubes were inserted to relieve pneumothorax, which had developed during endoscopic extraction. B-D. T2- (B), T1-weighted (C) and contrast-enhanced T1-weighted sagittal image (D) showing T1-2 spondylodiscitis with pre-vertebral extension. E-G. T2-weighted axial image (E) demonstrates diffuse hyperintensity in mediastinal planes. Pre- (F) and contrast-enhanced T1-weighted axial image (G) revealed diffuse enhancement in mediastinum suggesting mediastinitis.

Reference

1. Yardeni D, Yardeni H, Coran AG, Golladay ES. Severe esophageal damage due to button battery ingestion: can it be prevented? Pediatr Surg Int. 2004. 20:496–501.

2. Samad L, Ali M, Ramzi H. Button battery ingestion: hazards of esophageal impaction. J Pediatr Surg. 1999. 34:1527–1531.

3. Imamoglu M, Cay A, Kosucu P, Ahmetoglu A, Sarihan H. Acquired tracheo-esophageal fistulas caused by button battery lodged in the esophagus. Pediatr Surg Int. 2004. 20:292–294.

4. Chang YJ, Chao HC, Kong MS, Lai MW. Clinical analysis of disc battery ingestion in children. Chang Gung Med J. 2004. 27:673–677.

5. Van Asperen PP, Seeto I, Cass DT. Acquired tracheoesophageal fistula after ingestion of a mercury button-battery. Med J Aust. 1986. 145:412–415.

6. Anand TS, Kumar S, Wadhwa V, Dhawan R. Rare case of spontaneous closure of tracheo-esophageal fistula secondary to disc battery ingestion. Int J Pediatr Otorhinolaryngol. 2002. 63:57–59.

7. Banerjee R, Rao GV, Sriram PV, Pavan Reddy KS, Reddy DN. Button battery ingestion. Indian J Pediatr. 2005. 72:173–174.

8. Kost KM, Shapiro RS. Button battery ingestion: a case report and review of the literature. J Otolaryngol. 1987. 16:252–257.

9. Wadie GM, Konefal SH, Dias MA, McLaughlin MR. Cervical spondylodiscitis from an ingested pin: a case report. J Pediatr Surg. 2005. 40:593–596.

10. Fonga-Djimi H, Leclerc F, Martinot A, Hue V, Fourier C, Deschildre A, et al. Spondylodiscitis and mediastinitis after esophageal perforation owing to a swallowed radiolucent foreign body. J Pediatr Surg. 1996. 31:698–700.

11. Bolzoni A, Peretti G, Piazza C, Farina D, Nicolai P. Cervical spondylodiscitis: a rare complication after phonatory prosthesis insertion. Head Neck. 2006. 28:89–93.

12. Brunet A, Guillemin F, Bichet G, Gaucher A, Perrin C. Cervical spondylodiscitis. A rare complication of intubation. Ann Otolaryngol Chir Cervicofac. 1989. 106:40–43. [French].

13. Vigneswaran WT, Trastek VF, Pairolero PC, Deschamps C, Daly RC, Allen MS. Transhiatal oesophagectomy for carcinoma of the esophagus. Ann Thorac Surg. 1993. 56:838–846.

14. Kikendall JW. Caustic ingestion injuries. Gastroenterol Clin North Am. 1991. 20:847–857.

15. Eren S, Avci A, Nasir A, Gurkan F. Esophageal button battery ingestion: a delayed diagnosis. Turkish Respiratory Journal. 2007. 8:32–33.

16. Baum ED, Elden LM, Handler SD, Tom LW. Management of hypopharyngeal and esophageal perforations in children: three case reports and a review of the literature. Ear Nose Throat J. 2008. 87:44–47.