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Boletín Médico del Hospital Infantil de México

2008, Number 4

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Bol Med Hosp Infant Mex 2008; 65 (4)

How urgent is the extraction of a button disk battery located into the esophagus?

Blanco-Rodríguez G, Penchyna-Grub J, Ochoa-Guajardo PL, Álvarez-Neri H, Porras-Hernández JD, Teyssier-Morales G

Language: Spanish
References: 23
Page: 282-289
PDF size: 286.69 Kb.


ABSTRACT

Introduction. Foreign body ingestion is a common cause of consultation in the pediatric practice. Even though the most frequent ingested objects are coins, the button disk batteries are becoming a serious problem. Objectives: To describe the main esophageal lesions caused by the ingestion of button disk batteries, their response to treatment and clinical evolution.
Methods. Files from patients admitted to our hospital with diagnosis of button disk battery ingestion between December 1996 to December 2007 were reviewed. We analyzed sex, age, symptoms, evolution time, radiological and endoscopical findings, management, complications and long term sequels.
Results. We found 21 cases, male preponderance 4:1, age rank from 3 months to 12 years. Sialorrhea was the main symptom. Average time to treatment was 39.6 hours. Battery removal was accomplished with direct esophagoscopy using Jackson laryngoscope in 14 patients, rigid esophagoscope in 2 patients, and flexible esophagoscopy in 4. In most of the cases the battery was lodged in the proximal third of the esophagus. At endoscopic exploration, esophageal ulcers were found in 8 patients, necrosis in 6, ulcers and necrosis in 1, partial perforation in 1, perforation with traqueoesophageal fistula in 2, and no injury in 3 patients. Only 5 patients evolved to esophageal stenosis that resolved with dilatations. Two patients with perforation and traqueoesophageal fistula underwent surgical treatment, one of them died. Another patient with perforation was lost to follow up because of voluntary discharge.
Conclusions. Button disk battery ingestion is becoming a more frequent event; removal from the esophagus should be an urgent procedure to avoid severe complications such as stenosis and traqueoesophageal fistula.


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