Electric Insulating Irrigations Mitigates Esophageal Injury Caused by Button Battery Ingestion

Area of Science:

• Gastroenterology
• Pediatric Emergencies
• Toxicology

Background:

• Button battery (BB) ingestion causes rapid esophageal erosion, leading to severe complications and mortality.
• Current recommendations for BB ingestion include pH-neutralizing viscous solutions like honey and sucralfate to mitigate esophageal injury.
• Edible oils have shown potential in mitigating tissue damage from BB exposure.

Purpose of the Study:

• To compare the protective effects of kitchen oil (olive oil) with honey or sucralfate, and their mixture, against esophageal injury from BB ingestion.
• To evaluate the efficacy of these interventions in both ex vivo pig esophageal segments and in vivo piglets.

Main Methods:

• Olive oil, honey, sucralfate, and an olive oil-honey mixture (MOH) were used for irrigations in BB-exposed pig esophageal segments and live piglets.
• Esophageal injury was assessed through gross and histological analysis after BB exposure.
• BB voltage was monitored, and injury parameters like surface area, depth, and mucosal injury index were quantified.

Main Results:

• *In vitro*, olive oil showed better protection than honey or sucralfate.
• *In vivo*, olive oil alone exacerbated injury, causing esophageal perforation.
• The MOH demonstrated significant protective effects, superior to honey alone, by decreasing BB discharge, reducing injury area and depth, and lowering the mucosal injury index.

Conclusions:

• Olive oil alone is not protective and can be harmful in BB ingestion cases prior to surgical removal.
• A mixture of olive oil and honey (MOH) effectively prevents BB discharge and provides superior esophageal protection compared to honey alone.
• The MOH represents a promising therapeutic strategy for mitigating esophageal injury following button battery ingestion.