Clinical characteristics and serious complications of esophageal button battery ingestion in the pediatric on 83 cases.
10.3760/cma.j.cn115330-20221026-00632
- VernacularTitle:儿童纽扣电池食管异物83例临床特点及严重并发症分析
- Author:
Feng Zhen ZHANG
1
;
Qing Chuan DUAN
1
;
Gui Xiang WANG
1
;
Xiao Jian YANG
1
;
Wei ZHANG
1
;
Jing ZHAO
1
;
Hua WANG
1
;
Hong Bin LI
1
;
Xin NI
1
;
Jie ZHANG
1
Author Information
1. Department of Otorhinolaryngology Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, Beijing Key Laboratory for Pediatric Diseases of Otorhinolaryngology Head and Neck Surgery, National Center for Children's Health (NCCH), Beijing 100045, China.
- Publication Type:Journal Article
- MeSH:
Male;
Female;
Child;
Humans;
Infant;
Child, Preschool;
Tracheoesophageal Fistula/etiology*;
Retrospective Studies;
Foreign Bodies/diagnosis*;
Eating
- From:
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
2023;58(5):481-485
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To analyze the clinical characteristics and complications of esophageal foreign bodies of button battery ingestion in children. Methods: A retrospective descriptive study included 83 children who were hospitalized in our hospital on account of button battery ingestion from January 2011 to December 2021. There were 50 males (60.2%) and 33 females (39.8%). The age ranged from 7.6 months to one month off 10 years, with a median age of 18 months. The data of patient demographics and time from ingestion to admission, location, symptoms, management, complications, and follow-up outcome were recorded. SPSS17.0 software was used for statistical analysis. Results: Seventy-two children (86.7%) were younger than 3 years old. The time from ingestion to admission ranged from 1 h to 2 months, with a median time of 8 h. Among the 63 children who were first diagnosed in our hospital, the most common clinical symptoms were nausea and vomiting (32 cases, 50.8%), dysphagia (31 cases, 49.2%), salivation (11 cases, 17.5%) and fever (10 cases, 15.9%). Seventy-three of 83 cases had complete preoperative diagnostic tests, and 55 cases (75.3%) were diagnosed by X-ray. In 56 cases (76.7%), the foreign badies were impacted in the upper third of esophagus. In 72 cases (86.7%), the foreign badies were removed by rigid esophagoscopy. 23 (27.7%) had serious complications, including tracheoesophageal fistula in 15 cases(TEF;65.2%), vocal cord paralysis (VCP;34.8%) in 8 cases, esophageal perforation in 3 cases (EP;13.0%), hemorrhage in 3 cases(13.0%), mediastinitis in 3 cases (13%), and periesophageal abscess in 1 case (4.3%). There were significant differences in the exposure time of foreign bodies and unwitnessed ingestion by guardians in the complications group (P<0.05). 2 cases died (2.4%)respectively due to arterial esophageal fistula bleeding and respiratory failure caused by stent displacement during the treatment of tracheoesophageal fistula. Conclusion: Accidental button battery ingestion can be life-threatening. and it mostly happens in children under 3 years old. Serious complications may happen cause of non-specific clinical manifestations and unwitnessed ingestions. Anterior and lateral chest X-ray is the first examination choice. Tracheoesophageal fistula is the most common serious complication.
