Department of Otorhinolaryngology, Shenzhen Children's Hospital, 7019 Yitian Road, Futian District, Shenzhen, Guangdong, 518038, China.
BMC Pediatr. 2024 Jun 8;24(1):388. doi: 10.1186/s12887-024-04869-x.
To analyze the clinical characteristics of esophageal button battery impactions in children and explore safe and effective treatment methods.
This retrospective cohort study was conducted at a single tertiary care center, Shenzhen Children's Hospital, encompassing 89 children diagnosed with esophageal button battery impactions between January 2013 and January 2023. To minimize esophageal mucosal corrosion, prompt removal of the button battery with a first-aid fast track rigid esophagoscopy under general anesthesia was performed within thirty minutes of diagnosis. The clinical features and complications were recorded and analyzed.
Button battery as esophageal foreign body was prevalent among children under 3 years old (79.8%), with boys exhibiting a higher incidence rate (56.2%) compared to girls (43.8%), and an average age of 25.8 months. The median duration from ingestion to hospital admission was 3 h (range: 0.5 h to 3 months). Common symptoms included vomiting and dysphagia, with early stage vomiting of brown foamy secretions being a characteristic presentation of esophageal button battery impactions. The majority (77.5%) of batteries were lodged in the upper esophagus. The larger batteries were verified to be more prone to complications. All 89 cases exhibited varying degrees of esophageal mucosal erosion, with 31 cases (34.8%) experiencing severe complications, including esophageal stenosis in 11 cases (35.5%), esophageal perforation in 9 cases (29%) with 4 cases of tracheoesophageal fistula, vocal cord paralysis in 6 cases (19.4%), hemorrhage in 2 cases (6.5%), mediastinitis in 2 cases (6.5%), and periesophageal abscess in 1 case (3.2%). Despite the severity of these complications, none of the patients died after emergency surgery.
Esophageal button battery impactions can lead to significant damage to the esophageal mucosa due to its strong corrosiveness. Prompt action is crucial to mitigate the risk of complications. For the first time, we implement a first-aid fast track surgical intervention following diagnosis is imperative to minimize the incidence of adverse outcomes.
分析儿童食管纽扣电池嵌顿的临床特点，探讨安全有效的治疗方法。
本研究为单中心回顾性队列研究，纳入 2013 年 1 月至 2023 年 1 月在深圳市儿童医院就诊的 89 例食管纽扣电池嵌顿患儿。诊断后 30 分钟内，在全身麻醉下采用急救快速通道硬性食管镜检查，以尽量减少食管黏膜腐蚀，迅速取出纽扣电池。记录并分析临床特征和并发症。
纽扣电池作为食管异物，多见于 3 岁以下儿童（79.8%），其中男孩发病率（56.2%）高于女孩（43.8%），平均年龄为 25.8 个月。从吞食到入院的中位数时间为 3 小时（范围：0.5 小时至 3 个月）。常见症状包括呕吐和吞咽困难，早期呕吐棕色泡沫状分泌物是食管纽扣电池嵌顿的特征性表现。大多数（77.5%）电池位于食管上段。较大的电池更容易发生并发症。89 例均有不同程度的食管黏膜腐蚀，31 例（34.8%）发生严重并发症，其中食管狭窄 11 例（35.5%），食管穿孔 9 例（29%），其中 4 例合并气管食管瘘，声带麻痹 6 例（19.4%），出血 2 例（6.5%），纵隔炎 2 例（6.5%），食管周围脓肿 1 例（3.2%）。尽管并发症严重，但所有患者经急诊手术后均未死亡。
食管纽扣电池嵌顿可导致食管黏膜严重损伤，腐蚀性强。及时采取行动至关重要，以降低并发症风险。我们首次采用诊断后急救快速通道手术干预，可最大程度降低不良结局的发生率。
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