Multi-stage treatment of esophago-tracheal injury after button battery ingestion

MANAGEMENT OF COMPLICATIONS FOLLOWING BUTTON BATTERY INGESTION

Ingestion of button batteries by children is increasing every year, which is becoming a clinical problem for pediatricians. The number of complications and mortality when using batteries exceeds similar indicators when accidentally swallowing other foreign bodies. This is due to the electrochemical and mechanical effect of the battery on the mucous membrane of the gastrointestinal tract and especially the esophagus. With a late diagnosis, an ordinary battery leads to the development of fatal complications. In modern literature, there are no protocols that would relate to the treatment of similar situations, in particular, in the development of a tracheoesophageal fistula. The article describes a case of successful treatment of a tracheoesophageal fistula due to a long-term stay of a battery in the esophagus. This condition was also complicated by the development of bilateral tension pneumothorax. The dilemma in such cases is always difficult: to choose operative or conservative treatment. Both methods have their advantages and disadvantages. In this clinical case, preference was given to conservative treatment, which ended quite successfully. But the main goal is to prevent such situations. This can be achieved by raising parents' awareness of the risks of battery ingestion. Also, the efforts of a doctor who is faced with a similar situation should be directed to the fastest possible diagnosis and removal of such a foreign body as a battery.

A Rare Incidence of Neonatal Button Battery Ingestion: A Case of Child Abuse and Neglect

Foreign body (FB) ingestion is not uncommon, especially when the child beings coordination of the hands and mouth from 6 months to 5 years of age. However, FB ingestion in the neonatal period is extremely rare. We present a one-month-old baby with button battery ingestion to report the unusual age of presentation, unusual clinical findings, and child abuse. A radiopaque, spherical FB was visible in the upper chest on the chest X-ray. After performing an oesophagoscopy, the battery was removed, and the patient was put on a plan of anti-GERD medications and gradual nasogastric tube feeding. The patient was coping well under the supervision of the healthcare professional. However, the patient’s father decided to take the patient home against medical advice, and since then, no follow-up has been conducted by the patient’s guardians. In conclusion, neonatal foreign body ingestion is rare, and early detection and management can save neonates’ lives. Saudi Arabia’s national child protection teams, working under the National Family Safety Program, should strictly implement approved programs to prevent child abuse and teach positive parenting skills.

Diagnosis and Management of Button Battery Ingestion Complicated by Tracheo-Esophageal and Aorto-Esophageal Fistulas

Button battery ingestion (BBI) is common in children and its prevalence has increased in the last decades. BBI can be responsible for very severe and potentially fatal complications if not promptly detected. We describe the successful management of two cases of BBI that occurred in two previously healthy infants. Both patients presented with vague symptoms and no witness of foreign body ingestion. The prolonged time of exposure to the corrosive effects of disk batteries was responsible for the development of tracheo-esophageal fistula (TEF) and aorto-esophageal fistula (AEF). We demonstrate how prompt diagnosis and management are crucial for the infants’ survival.