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Spondylodiscitis following ingestion of button battery in an infant—a case-based update

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Abstract

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.

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Abbreviations

CT:

Computed tomography

CRP:

C reactive protein

ESR:

Erythrocyte sedimentation rate

MRI:

Magnetic resonance imaging

OGD:

Oesophagogastroduodenoscopy

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Authors and Affiliations

  1. Department of Neurosurgery, Birmingham Children’s Hospital, Steelhouse Lane, Birmingham, B4 6NH, UK

    Fardad T. Afshari & William B. Lo

  2. Department of Paediatric Surgery, Birmingham Children’s Hospital, Steelhouse Lane, Birmingham, B4 6NH, UK

    Oliver Gee

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  1. Fardad T. Afshari
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  2. Oliver Gee
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  3. William B. Lo
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Fardad Afshari has written the article with further input and supervision from Oliver Gee and William Lo.

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Correspondence to Fardad T. Afshari.

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Afshari, F.T., Gee, O. & Lo, W.B. Spondylodiscitis following ingestion of button battery in an infant—a case-based update. Childs Nerv Syst 39, 2233–2236 (2023). https://doi.org/10.1007/s00381-023-05949-6

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  • DOI: https://doi.org/10.1007/s00381-023-05949-6

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