Babies and batteries

Correspondence to: Dr Jolita Bekhof j.bekhof@isala.nl A 6-week-old girl was admitted in October, 2003, with respiratory distress and feeding problems. We examined her, did blood tests and a chest radiograph, and gave her antibiotics. We failed at several attempts to pass a nasogastric tube. 24 h later, she was in respiratory failure, and we transferred her to intensive care, where she was intubated and ventilated. A second radiograph (figure, A) showed two foreign bodies in the oesophagus, that we had assumed were electrocardiography pads on the radiograph taken at admission. On endoscopy, we found extensive tracheo-oesophageal lacerations and fistulas, and we retrieved two alkaline button batteries (figure, B) from the proximal oesophagus. The baby was ventilated for 1 month and tube fed through a jejunostomy while the lacerations healed. Tracheal resection and end-to-end anastomosis was done in April, 2004, but one of the fistulas persisted, which we are treating conservatively. Despite having spent almost a year in hospital, the child is thriving, and has reached normal growth and developmental milestones. We have been reminded to systematically interpret every radiograph, and to never underestimate a baby’s ability to swallow small objects. Babies and batteries