Pediatric Surgery Department, IRCCS Istituto Giannina Gaslini, Via Gerolamo Gaslini 5, 16147, Genoa, Italy.
Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Science, University of Genoa, Genoa, Italy.
Pediatr Surg Int. 2024 Oct 9;40(1):268. doi: 10.1007/s00383-024-05849-z.
Disk battery (DB) ingestion in children can lead to severe complications and mortality. This study details our experience in managing DB ingestion and its complications.
We analyzed data from all patients treated for DB ingestion at our hospital from June 2010 to January 2024. A protocol established in 2010 requires angio-CT scans for esophageal DB cases and a multidisciplinary approach involving gastroenterologists, otolaryngologists, pediatric and airway surgeons, and cardiac surgeons.
We treated 22 patients. In June 2010, following the tragic death of a patient from an undiagnosed DB ingestion that led to an aortoesophageal fistula, our protocol was established. All DBs were removed endoscopically. Four patients needed additional surgery: two had tracheal resection/anastomosis and esophageal repair for large tracheoesophageal fistulas; one required aortic wall reinforcement with a patch; one underwent endoscopic removal with a sternal split to explore the aortic arch. All 22 patients survived and recovered clinically. One developed bilateral vocal cord palsy as a complication.
Effective management of DB ingestion complications necessitates a collaborative, multidisciplinary approach. Our protocol has improved management strategies and patient outcomes.
儿童吞食盘状电池（DB）可导致严重并发症和死亡。本研究详细介绍了我们治疗 DB 吞食及其并发症的经验。
我们分析了 2010 年 6 月至 2024 年 1 月期间在我院接受 DB 吞食治疗的所有患者的数据。2010 年制定的方案要求对食管 DB 病例进行血管造影 CT 扫描，并采用多学科方法，涉及胃肠病学家、耳鼻喉科医生、儿科和气道外科医生以及心脏外科医生。
我们共治疗了 22 名患者。2010 年 6 月，一名患者因未确诊的 DB 吞食导致主动脉食管瘘而不幸死亡后，我们制定了该方案。所有 DB 均通过内镜取出。4 名患者需要额外手术：2 例因大的气管食管瘘而行气管切除术/吻合术和食管修复；1 例因主动脉壁用补片加固；1 例通过胸骨劈开进行内镜移除以探查主动脉弓。所有 22 例患者均存活并临床康复。1 例出现双侧声带麻痹并发症。
有效管理 DB 吞食并发症需要协作、多学科的方法。我们的方案改善了管理策略和患者结局。
