Left Common Carotid Artery Pseudoaneurysm After Unwitnessed Lithium Button Battery Ingestion in a Toddler: Successful Endovascular Hemostasis Following Life-Threatening Bleeding

The landscape of pediatric injury has shifted dramatically alongside the strategic evolution of household electronics.As consumer technology pursues extreme miniaturization, manufacturers have increasingly transitioned to high-energy-density lithium-ion chemistries.The strategic challenge for the clinician is that a battery small enough to be swallowed by infants and toddlers is often large enough to bridge the esophageal lumen, initiating catastrophic tissue destruction within minutes.Commonly, mucosal injury begins within 15 minutes, and full-thickness burns can occur within 4 hours, with severe complications, such as vocal cord paralysis, spondylodiscitis, aorto-esophageal stricture/stenosis, tracheoesophageal fistula (TEF), or aorto-esophageal fistula (AEF).In the article, we present a successful multidisciplinary management of an extremely rare clinical case: a 2-year-old female patient with trisomy 21 who experienced severe bleeding from a left carotid pseudoaneurysm following ingestion of a CR2032 3V Lithium button battery, treated with endovascular repair.This case highlights that (i) severe injury may evolve despite early removal, (ii) bleeding after button battery ingestion warrants urgent vascular evaluation, and (iii) carotid-esophageal fistula, though rare, should be considered in recurrent bright-red hematemesis following esophageal button battery injury.