Dr. Kendall Crowns

Food is the most common reason for pediatric choking and is one of the things we see the most at autopsy.

I've seen other cases of non-food related items.

I have had one that was actually quite an unusual case of choking.

The child didn't die initially from the choking incident, but from a later complication,

And what he had swallowed was a cylindrical battery, triple A to be exact.

In this case, he was a four and a half year old male.

He had developmental disabilities, and his brother had actually been feeding him Cheetos when he decided to switch and give him a battery, which the child swallowed.

He was noticed after swallowing the battery to be choking on something.

He was given a drink of water and appeared to be no longer in distress.

The next day, the child had throat pain, trouble swallowing, fever, and was throwing up.

He was taken to the hospital, and a CT was performed, and it showed a battery was stuck in his esophagus.

They were surgically able to remove the battery, but the thing about it is, when batteries get in your throat, especially button batteries, they can generate an electrical current in the tissue fluids, and that produces hydroxide at the negative pole of the battery, leading to corrosive mucosal burns.

and these burns can erode through the esophagus into the surrounding tissues.

And that's what happened in this case.

The child had mucosal injuries, but what had happened was the injuries were deeper than just the esophagus.

They had burned through into the surrounding blood vessels near the esophagus, and eventually these erosions burst.

The child initially started with nosebleeds, and as they were trying to control them, he began suddenly vomiting blood.

and a lot of it, and it happened so quickly they couldn't stop it, and he eventually bled out in a manner of minutes.

At autopsy, what I found is one ulcer in his esophagus had gone completely through the esophagus and then completely through the aorta, creating what is known as an aortic esophageal fistula, which means there is a bridge between the aorta and the esophagus that

leading to blood getting into the esophagus.