Afshari Fardad T, Gee Oliver, Lo William B
Department of Neurosurgery, Birmingham Children's Hospital, Steelhouse Lane, Birmingham, B4 6NH, UK.
Department of Paediatric Surgery, Birmingham Children's Hospital, Steelhouse Lane, Birmingham, B4 6NH, UK.
Childs Nerv Syst. 2023 Aug;39(8):2233-2236. doi: 10.1007/s00381-023-05949-6. Epub 2023 Apr 13.
Button battery ingestion in infants is an increasingly common surgical emergency which can lead to oesophageal perforation, mediastinitis, trachea-oesophageal fistulation, airway compromise and death. One exceedingly rare complication of battery ingestion is discitis and osteomyelitis in the cervical and upper thoracic spine. Diagnosis is normally delayed due to the non-specific presentation, delayed imaging findings and the initial clinical focus on dealing with the immediate, and potentially life-threatening, complications. We describe a case of a 1-year-old girl who presented with haematemesis and an oesophageal injury, secondary to button battery ingestion. Sagittal reconstruction of the CT chest demonstrated a suspicious area of vertebral erosion in the cervicothoracic spine which prompted a further evaluation with MRI demonstrating spondylodiscitis of C7-T2 with vertebral erosion and collapse. The child was successfully treated with long course of antibiotics. We wish to highlight the importance of clinical and radiological spinal assessment in children with button battery ingestion to avoid delayed diagnosis and complications of spinal osteomyelitis.
婴儿吞食纽扣电池是一种日益常见的外科急症，可导致食管穿孔、纵隔炎、气管食管瘘、气道受压及死亡。电池吞食极为罕见的一种并发症是颈椎和上胸椎的椎间盘炎和骨髓炎。由于表现不具特异性、影像学检查结果出现延迟以及最初临床重点在于处理即刻且可能危及生命的并发症，诊断通常会延迟。我们描述了一例1岁女童病例，该女童因吞食纽扣电池出现呕血和食管损伤。胸部CT矢状面重建显示颈胸段脊柱有一个可疑的椎体侵蚀区域，这促使进一步进行MRI检查，结果显示C7 - T2椎体椎间盘炎伴椎体侵蚀和塌陷。该患儿通过长期使用抗生素成功治愈。我们希望强调对吞食纽扣电池儿童进行临床和影像学脊柱评估的重要性，以避免脊柱骨髓炎的诊断延迟和并发症。
