Life threatening situation? Always call 112

Case study: button cell battery ingestion in a small child by regional committee of inquiry

A coin cell battery Ingestion can have major consequences for a child. Recently, such a situation occurred, where the incident was not recognized. After 10 days the 14-month-old child was admitted with severe shortness of breath, a battery on the chest X-ray became visible by surprise. An emergency procedure and ICU admission was necessary to alleviate the severe damage to the oesophagus. repair. This was followed by a long recovery phase; both somatic and psychological the incident has left its mark.

How Do you recognize it?                                               

For a corpus alienum ingestion, especially a button cell battery: you have to think about it!! The initial complaints were: acute moment, after which the child became restless, a large gave up the amount of white mucus, didn’t want to eat and drank less, vomited. From the beginning there was shortness of breath (pseudocroup-like) about the 9 days Increased.

There is not a guideline for general practitioners on this subject. The FMS mentions as symptoms: wheezing, coughing, stridor and choking, drooling, dysphagia, odynophagia (pain when swallowing), globus sensation, vomiting, food refusal, abdominal pain, chest pain, fever and irritability. A sore neck and Drooling in food bolus impaction indicates an esophageal obstruction.

However The absence of symptoms does not preclude ingestion of a corpus alienum. After all, 90% leave the body without any problems. The story of the parents is leading.

When there is suspicion, a chest X-ray is the appropriate examination.


What stood out about the case was that the acute moment was not recognized as such. The first triage nurse and doctors have a key role in this. The doctors who follow will hear more about the Then walk about that important acute moment. The disadvantage was and is in the that the individual symptoms were not alarming and that it was the child’s condition is not such that immediate action is taken. had to be.

Another pitfall is the large number of stakeholders; In 9 days, numerous triage nurses will have parents and numerous doctors have seen the child, including a number of contacts with their own GPs. Even it is because of pseudocroup complaints by the pediatrician treated; He (temporarily) recovered with the treatment (dexamethasone). None of the doctors have seen the child twice. This would the opportunity to make a comparison.

Reading back, the shortness of breath gradually increases. There was no fever, and there was no difference between morning and evening. It resembled pseudocroup, but atypical. Perhaps this will be signalled when one of the people involved is alerted through the many contacts, together with parents, lists the entire course.


  • Remember at acute beginning, ask for it. Be alert to the above complaints.
  • In the event of a course of illness over a number of days: Try to get an overview.
  • Be alert to an atypical course (and therefore atypical cause).
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