Department of Pediatrics.
Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Curr Opin Pediatr. 2018 Oct;30(5):653-659. doi: 10.1097/MOP.0000000000000665.
Pediatric foreign body ingestion is a common occurrence that presents a challenge both to pediatric gastroenterologists and primary care providers. Increasing prevalence of smaller, more technologically advanced toys in the household has resulted in an increased exposure to higher voltage batteries and powerful magnets that carry a high incidence of morbidity and mortality. This review highlights the latest findings regarding the patients at risk for button battery and magnet ingestions, the symptoms of presentation, and complications of these objects in contributing to long-standing gastrointestinal injury.
Button batteries may lead to esophageal injury within a few hours. Batteries retained in the esophagus are larger in diameter on average and size is associated with esophageal impaction as well as higher grade esophageal injury. Magnet ingestions, when multiple or with another metallic object, are often initially asymptomatic but may have acute worsening, and therefore warrant close monitoring.
Button battery and magnet ingestions have increased in incidence over the past two decades. Recent literature demonstrates that higher voltage, larger lithium button batteries, and prevalence of high-powered magnets can lead to significant morbidity. High suspicion, early referral, and removal may lead to improved outcomes.
小儿异物吞食较为常见，这对儿科胃肠病学家和初级保健提供者来说都是一个挑战。家庭中越来越多的小而技术先进的玩具的出现，导致人们接触到更高电压的电池和强力磁铁的机会增加，而这些物品的发病率和死亡率都很高。本文重点介绍了有关纽扣电池和磁铁吞食风险的最新发现，以及这些物品导致长期胃肠道损伤的临床表现和并发症。
纽扣电池可能在几小时内导致食管损伤。电池在食管中停留的直径较大，平均直径与食管嵌顿以及更高级别的食管损伤有关。当吞食多个磁铁或与另一个金属物体时，最初通常无症状，但可能会出现急性恶化，因此需要密切监测。
在过去的二十年中，纽扣电池和磁铁的摄入发生率有所增加。最近的文献表明，高电压、较大的锂电池和高功率磁铁的出现会导致严重的发病率。高度怀疑、早期转介和取出可能会改善预后。
