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Emergency Medicine Journal 2007;24:e15; doi:10.1136/emj.2006.044180
© 2007 BMJ Publishing Group Ltd and the College of Emergency Medicine.

EMERGENCY CASEBOOK

Lodged oesophageal button battery masquerading as a coin: an unusual cause of bilateral vocal cord paralysis

Jonathan Michael Bernstein, Stuart A Burrows, Michael W Saunders

Bristol Royal Hospital for Children, Bristol, UK

Correspondence to:
Correspondence to:
J M Bernstein
Department of ENT, St Michael’s Hospital, Southwell Street, Bristol BS2 8EH, UK; jbernstein{at}nhs.net

ABSTRACT

An 11-month-old girl with an oesophageal foreign bodywas presented: from the radiographic appearance it was presumed to be a coin. Microlaryngoscopy 5 h after ingestion revealed a button battery impacted in the hypopharynx with severe damage to the oesophageal mucosa. The patient was intubated for 6 days in the intensive care unit because of stridor and respiratory distress. Repeat microlaryngoscopy demonstrated bilateral vocal cord palsy, which was presumed to be secondary to the involvement of the recurrent laryngeal nerves in the injury. We recommend that in the absence of a history of observed ingestion, it should be assumed that coin-like foreign bodies are button batteries until proven otherwise.


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