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2021, Number 5

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Acta Pediatr Mex 2021; 42 (5)

Button battery retention in esophagus for 7 months in a 2-year-old patient: A case report and bibliographic review

Brenes-Guzmán S, Puga-Ayala VM

Language: Spanish
References: 28
Page: 241-246
PDF size: 331.49 Kb.


ABSTRACT

Background: Most foreign body ingestions occur in older infants and preschoolers. Almost all of them are asymptomatic. The most frequently ingested objects are: coins and button batteries that can generate serious sequelae. Ten to 20% of swallowed objects require removal by endoscopy and less than 1% by surgery. The severity of the lesions and complications are closely related to the time of exposure to the foreign body.
Clinical case: Two-year-old female patient with a history of nausea seven months earlier. The parents remembered having seen her playing with a battery, but without evidence that she had ingested it. Five months before coming for consultation, she started with regurgitation 1 to 2 times per week, malaise that evolved to regurgitation and postprandial emesis at all meals; in addition to sialorrhea and refusal to eat. No alterations were found in the physical examination. Radiography showed the existence of a circular metallic object, like a button battery. CT showed no apparent lesions in the surrounding tissues. Removal of the battery was attempted endoscopically but was unsuccessful. Removal was achieved by surgical intervention by right posterolateral posterolateral thoracotomy, with esophagotomy and esophagoplasty.
Conclusions: Proper medical care of patients with suspected foreign body ingestion is critical to their prognosis. The evaluation should include a thorough clinical history and adequate physical examination. The diagnosis should always be suspected in patients with regurgitation, vomiting, refusal to feed, respiratory symptoms that do not subside despite treatment, especially in older infants and preschoolers.


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