Lukish Annamarie C, Pat Vivien, Apte Anisha, Levitt Marc A
Division of Colorectal and Pelvic Reconstructive Surgery, Children's National Medical Center, Washington, District of Columbia, United States.
Division of Medicine, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, United States.
European J Pediatr Surg Rep. 2022 Mar 10;10(1):e41-e44. doi: 10.1055/s-0041-1741558. eCollection 2022 Jan.
Disc and button battery ingestion in children is common. In fact, data reports a dramatic increase in battery ingestion during the coronavirus disease 2019 pandemic likely as a result of increased household population density and electronic product utilization. These batteries often remain lodged in the esophagus causing potentially devastating complications if they are not removed urgently. Batteries that are passed beyond the esophagus usually do not cause any complications. We present the case of a 15-month-old male who underwent a colostomy takedown 2 months following a posterior sagittal anorectoplasty for imperforate anus. He recovered quickly, was advanced on his diet, and was discharged to home on postoperative day 3. On postoperative day 5 following the stoma closure, he presented with an acute abdomen, pneumoperitoneum and an abdominal X-ray that revealed a 21 mm disc battery in the left lower quadrant. He underwent exploration and the battery was found perforating the anastomosis. There was significant fibropurulent exudate and inflammation. The battery was removed, the anastomosis was excised, and a colostomy with Hartman's pouch was performed. The toddler recovered uneventfully. This case offers an opportunity to discuss the concerns of battery ingestion and postoperative care following intestinal surgery in children. We could find no other similar reports in the world's literature of a disrupted colonic anastomosis due to battery ingestion.
儿童吞食圆盘形和纽扣形电池的情况很常见。事实上,数据显示在2019年冠状病毒病大流行期间,电池吞食情况急剧增加,这可能是家庭人口密度增加和电子产品使用增多的结果。这些电池常常滞留在食管内,如果不紧急取出,可能会导致极具破坏性的并发症。通过食管的电池通常不会引起任何并发症。我们报告一例15个月大的男性病例,该患儿在接受先天性肛门闭锁后矢状位肛门直肠成形术2个月后接受了结肠造口还纳术。他恢复很快,饮食逐渐增加,并在术后第3天出院。在造口关闭后的术后第5天,他出现急腹症、气腹,腹部X线显示左下腹有一枚21毫米的圆盘形电池。他接受了探查,发现电池已穿透吻合口。有大量纤维脓性渗出物和炎症。取出电池,切除吻合口,并进行了带哈特曼袋的结肠造口术。这名幼儿恢复顺利。该病例提供了一个机会,来讨论儿童肠道手术后电池吞食问题及术后护理。在世界文献中,我们未发现因电池吞食导致结肠吻合口破裂的其他类似报告。