Tracheo-esophageal fistula following disc battery ingestion and foreign body impaction

Background: Ingestion of foreign bodies (FB) and disc batteries (DB) may result in the formation of a trachea-esophageal fistula (TEF), which causes severe morbidity in children. We describe four cases of TEF, who underwent emergent surgery for repair.Case presentation: In this report, we present four patients aged between 9 months to 2.5 years, who referred due to disc battery ingestion in 3 cases and foreign ingestion in one. There were two boys and two girls. The common symptoms were cough, cyanosis, and dysphasia, choking and vomiting. The diagnosis was performed through an x-ray, barium swallow and CT scan. All batteries and foreign body were impacted in the esophagus, two in upper, one in the middle, and one in lower esophagus. All disc batteries and FB were removed endoscopically, but Patients had developed trachea-esophageal fistula (TEF). All patients underwent TEF repaired surgically. There was no morbidity in four patients, but one patient developed moderate esophageal stenosis, which was treated by staged dilatation. There was no mortality in our cases.Conclusion:Long-term impaction of foreign bodies may result in trachea-esophageal fistula. This complication may be seen earlier with alkaline disc batteries. Removal of these foreign bodies should be followed carefully for the diagnosis and treatment of these fistulas