Sudden death of a 2-year-old child after ingestion of a button battery

Medicolegal aspects

Plötzlicher Tod eines 2‑jährigen Kindes nach Verschlucken einer Knopfbatterie

Medikolegale Aspekte

Abstract

A dramatic rise in the rate of fatal button battery injuries (BBI) among children under the age of 4 years has been described over the past decade. In the present case a 22-month-old child died after sudden onset of blood vomiting of unknown origin. A forensic autopsy revealed a button battery lodged in the esophagus with fatal fistulation into the thoracic aorta. Given all these findings, the cause of death was a massive hemorrhage due to ingestion of a button battery resulting in ulceration of the esophagus and penetration of the aortic wall. With respect to the clinical history and unspecific clinical symptoms, malpractice in terms of a missed diagnosis could not be proven.

Zusammenfassung

In den letzten 10 Jahren ist es zu einem dramatischen Anstieg an dokumentierten Fällen über verschluckte Knopfbatterien mit letalen Verläufen gekommen, wie auch im vorliegendem Fall: Ein 22 Monate altes Kind verstarb kurz nach Einlieferung in die Notaufnahme, nachdem es zuvor während des Abendessens plötzlich Blut erbrochen habe. Eine am Folgetag durchgeführte Obduktion erbrachte den Nachweis einer Knopfbatterie, die im unteren Drittel des Ösophagus steckte und zu einer aortoösophagealen Fistel mit konsekutivem Verbluten nach innen geführt hat. Aufgrund unspezifischer Symptome nach Verschlucken einer Knopfbatterie ist die Diagnosestellung oftmals erschwert. Im vorliegenden Fall konnte ein ärztliches Fehlverhalten nicht bewiesen werden.

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Correspondence to A.-K. Kröll.

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A.-K. Kröll, N. Schaefer, A. Kiefer and P. Schmidt declare that they have no competing interests.

The investigations were carried out according to the specifications of the Central Ethics Committee of the Federal Medical Council.

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Kröll, A., Schaefer, N., Kiefer, A. et al. Sudden death of a 2-year-old child after ingestion of a button battery. Rechtsmedizin 28, 301–306 (2018). https://doi.org/10.1007/s00194-017-0224-4

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Keywords

  • Childhood
  • Foreign body
  • Aorta
  • Esophageal fistula
  • Exsanguination

Schlüsselwörter

  • Kindesalter
  • Fremdkörper
  • Aorta
  • Aortoösophageale Fistel
  • Verbluten