Department of Anaesthesia and Critical Care, Tygerberg Hospital, Cape Town, South Africa.
S Afr Med J. 2020 Jul 7;110(7):652-656. doi: 10.7196/SAMJ.2020.v110i7.14481.
Ingestion of foreign bodies remains a frequent reason for presentation to paediatric emergency departments worldwide. Among the variety of objects ingested, button batteries are particularly harmful owing to their electrochemical properties, which can cause extensive injuries if not diagnosed and treated rapidly. International trends show an increasing incidence of button battery ingestion, leading to concern that this pattern may be occurring in South Africa. Limited local data on paediatric foreign body ingestion have been published.
To assess battery ingestion rates in a tertiary paediatric hospital. We hypothesised that the incidence has increased, in keeping with international trends. Secondary objectives included describing admission rates, requirements for anaesthesia and surgery, and promoting awareness of the problems associated with battery ingestion.
We performed a retrospective, descriptive analysis of the Red Cross War Memorial Children's Hospital trauma database, including all children under 13 years of age seen between 1 January 2010 and 31 December 2015 with suspected ingestion of a foreign body. The ward admissions database was then examined to find additional cases in which children were admitted directly. After exclusion of duplicate records, cases were classified by type of foreign body, management, requirement for admission, anaesthesia and surgery. Descriptive statistics were used to analyse the data in comparison with previous studies published from this database.
Patient age and gender patterns matched the literature, with a peak incidence in children under 2 years of age. Over the 6-year period, 180 patients presented with food foreign bodies, whereas 497 objects were classified as non-food. After exclusion of misdiagnosed cases, the remaining 462 objects were dominated by coins (44.2%). Batteries were the causative agent in 4.8% (22/462). Although the subtypes of batteries were not reliably recorded, button batteries accounted for at least 64% (14/22). Most children who ingested batteries presented early, but more required admission, anaesthesia and surgery than children who ingested other forms of foreign body.
The study demonstrated that the local incidence of button battery ingestion may be increasing, although data are still limited.Admission, anaesthesia and surgery rates for batteries were higher in this cohort than for all other foreign bodies. As button batteries can mimic coins, with much more dire consequences on ingestion, our ability to expedite diagnosis and management hinges on a high index of suspicion. It is imperative to increase awareness among healthcare workers and parents.
在全球范围内，吞食异物仍然是儿科急诊就诊的常见原因。在各种吞食的异物中，纽扣电池由于其电化学特性而特别有害，如果不能迅速诊断和治疗，可能会造成广泛的损伤。国际趋势表明纽扣电池吞食的发生率在不断增加，这让人担心这种模式可能正在南非发生。关于儿科异物吞食的本地数据有限。
评估一家三级儿科医院的电池吞食率。我们假设，与国际趋势一致，这一发病率有所增加。次要目标包括描述入院率、麻醉和手术需求，并提高对与电池吞食相关问题的认识。
我们对红十字会战争纪念儿童医院创伤数据库进行了回顾性描述性分析，纳入 2010 年 1 月 1 日至 2015 年 12 月 31 日期间所有年龄在 13 岁以下、疑似吞食异物的儿童。然后，检查病房入院数据库以找到直接入院的其他病例。排除重复记录后，根据异物类型、处理方法、入院、麻醉和手术要求对病例进行分类。使用描述性统计数据对数据进行分析，并与该数据库发表的以前的研究进行比较。
患者年龄和性别模式与文献一致，2 岁以下儿童的发病率最高。在 6 年期间，有 180 名患者因食物异物就诊，而 497 名患者被归类为非食物。排除误诊病例后，其余 462 名患者主要为硬币（44.2%）。电池是 4.8%（22/462）的致病原因。虽然电池的亚类没有可靠记录，但纽扣电池至少占 64%（14/22）。大多数吞食电池的儿童就诊较早，但需要入院、麻醉和手术的比例高于吞食其他形式异物的儿童。
该研究表明，纽扣电池吞食的本地发病率可能在增加，尽管数据仍然有限。在这组人群中，电池的入院、麻醉和手术率高于所有其他异物。由于纽扣电池可以模仿硬币，吞食后后果更为严重，因此我们快速诊断和治疗的能力取决于高度怀疑。提高医护人员和家长的认识至关重要。
