Wolter Nikolaus E, Siu Jennifer M, Davidson Jacob, Bhatt Ayushi, Ostrow Olivia, Rourke Ryan, Hong Xinyuan, Maclean Jonathan, Pugi Jakob, Pulkki Kristina H, Philteos Justine G, Graham M Elise, Seemann Natashia M
Department of Otolaryngology - Head & Neck Surgery, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada.
Department of Surgery, Western University, London, ON, Canada.
CJEM. 2025 Sep 17. doi: 10.1007/s43678-025-01010-4.
Esophageal button battery impactions represent a life-threatening medical emergency in children. There are established clinical benchmarks to help reduce the risk of injury. Our objective was to describe the care pathways of children presenting with esophageal button battery impactions in the four main pediatric centers in Ontario.
A multi-institutional health records review of button battery ingestion cases in children from 2012 to 2023 at four large-volume tertiary pediatric hospitals was conducted. Participants included children under 18 years who underwent esophagoscopy for battery removal.
Eighty-six children with button battery impactions were identified. The median age was 2.6 years. Fifteen children presented directly to a tertiary institution, while 71 (82.6%) were transferred from a community hospital. The median total distance traveled was 44.6 km. The median time from button battery diagnosis to removal was 7.9 h. Honey or sucralfate was administered in < 5% of cases. The median hospital stay was 3.1 days. Complications included esophageal perforation (2.3%), esophageal stricture (8.5%), tracheoesophageal fistula (1.2%), and vascular injury (1.2%), with one death reported. No cases met the benchmark of button battery removal within 2 h of ingestion, with significant delays occurring at every management stage.
Despite efforts to increase awareness and rapid management of button battery ingestion, significant delays, poor adherence to mitigation strategies, and serious complications persist. These findings emphasize the need for prevention and the development of regional and institution-specific protocols to provide timely and streamlined care.
食管纽扣电池嵌顿是儿童危及生命的医疗急症。已有既定的临床基准来帮助降低受伤风险。我们的目的是描述安大略省四个主要儿科中心中出现食管纽扣电池嵌顿的儿童的护理路径。
对2012年至2023年四家大型三级儿科医院儿童纽扣电池摄入病例进行多机构健康记录审查。参与者包括18岁以下因取出电池而接受食管镜检查的儿童。
确定了86例纽扣电池嵌顿儿童。中位年龄为2.6岁。15名儿童直接前往三级医疗机构，而71名（82.6%）从社区医院转诊。总行程中位数为44.6公里。从纽扣电池诊断到取出的中位时间为7.9小时。不到5%的病例使用了蜂蜜或硫糖铝。中位住院时间为3.1天。并发症包括食管穿孔（2.3%）、食管狭窄（8.5%）、气管食管瘘（1.2%）和血管损伤（1.2%），报告了1例死亡。没有病例在摄入后2小时内达到纽扣电池取出的基准，在每个管理阶段都出现了显著延迟。
尽管努力提高对纽扣电池摄入的认识并进行快速处理，但仍存在显著延迟、对缓解策略的依从性差以及严重并发症。这些发现强调了预防的必要性以及制定区域和机构特定方案以提供及时和简化护理的必要性。
