Ventura Francesco, Candosin Sara, Barranco Rosario, Bonsignore Alessandro, Andrello Luisa, Tajana Luca, Osculati Antonio
From the *Department of Legal and Forensic Medicine, University of Genova, Genova, Italy; †Legal Medicine Service, Canton of Ticino, Switzerland; and ‡Department of Public Health, Forensic and Experimental Medicine, University of Pavia, Pavia, Italy.
Am J Forensic Med Pathol. 2017 Mar;38(1):43-46. doi: 10.1097/PAF.0000000000000297.
The ingestion of extraneous substances is quite common in clinical practice; it usually befalls in the pediatric age, mostly between 6 months and 6 years. In most cases, complications do not emerge, and the prognosis is considered favorable. However, when a case of battery ingestion occurs, serious adverse events may develop. The ingestion of these components is a potential life-threatening event for children.In this article, we report the case of an 18-month-old child who died from hemorrhagic shock due to an aortoesophageal fistula caused by a 20 mm lithium button battery lodged in the esophagus.The child presented vomiting blood, and laboratory results revealed a severe anemization, which later led to death.The autopsy showed a coin battery located in the middle third of the esophagus as well as a transmural erosion of the esophageal wall with fistulization into the aortic wall. The histological examination revealed a severe necrosis of the esophageal and aortic walls in line with the junction between the aortic arch and the descending part.
在临床实践中,摄入异物的情况相当常见;这种情况通常发生在儿童时期,大多在6个月至6岁之间。在大多数情况下,不会出现并发症,预后被认为良好。然而,当发生吞食电池的情况时,可能会出现严重的不良事件。摄入这些部件对儿童来说是潜在的危及生命的事件。在本文中,我们报告了一名18个月大的儿童因一枚20毫米锂纽扣电池嵌顿在食管导致主动脉食管瘘,最终死于失血性休克的病例。该儿童出现吐血症状,实验室检查结果显示严重贫血,最终导致死亡。尸检显示一枚硬币电池位于食管中三分之一处,食管壁有透壁性糜烂并形成瘘管通向主动脉壁。组织学检查显示食管和主动脉壁严重坏死,与主动脉弓和降部的交界处一致。