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Esophageal Button Battery in the Pediatric Population: Experience from a Tertiary Care Center

Sachit Anand1, Vishesh Jain2, Sandeep Agarwala1

  • 1Department of Pediatric Surgery, All India Institute of Medical Sciences, New Delhi, India.

Indian Journal of Pediatrics
|February 17, 2020
PubMed

Insights

Button battery ingestion in children is dangerous, often presenting with vague symptoms. Urgent endoscopic removal is key, and while injuries can be severe, long-term esophageal issues were not observed in survivors.

Area of Science:

  • Pediatric Gastroenterology
  • Emergency Medicine
  • Otolaryngology

Background:

  • Button battery ingestion is a critical pediatric emergency.
  • Delayed diagnosis is common due to non-specific symptoms and unwitnessed ingestions.
  • Ingestion can lead to severe esophageal injury and life-threatening complications.

Purpose of the Study:

  • To describe clinical presentations of button battery ingestion in children.
  • To share management experiences and outcomes.
  • To highlight patterns of injury and long-term sequelae.

Main Methods:

  • A 5-year descriptive cohort study (January 2014-December 2018).
  • Urgent rigid esophagoscopy for battery removal.
  • Post-operative monitoring for complications and follow-up contrast esophagogram at 4-6 weeks.

Main Results:

  • Fifty-two children managed; most common source was electronic appliance remotes.
  • Vomiting, dysphagia, and chest pain were common symptoms.
  • Majority of batteries lodged in the upper esophagus; Grade 3 and 2 injuries seen in 59% and 41% respectively.
  • Two deaths occurred due to aorto-esophageal and tracheoesophageal fistulas.
  • Survivors showed no long-term clinical or radiological sequelae.

Conclusions:

  • Button battery ingestion poses significant risks, including mortality.
  • Early diagnosis and prompt endoscopic retrieval are crucial.
  • Despite initial severe esophageal injury, children can achieve good long-term outcomes without sequelae.
Abstract

Keywords:
Aorto-esophageal fistulaButton batteryContrast esophagogramEsophagusRigid esophagoscopyTracheo-esophageal fistula

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