Wang Ping,Li Yun,Luo Xinyou,et al.The therapeutic effect for 22 children with esophageal foreign bodies of button battery[J].Journal of Clinical Pediatric Surgery,,18():467-471.[doi:10.3969/j.issn.1671-6353.2019.06.007]
The therapeutic effect for 22 children with esophageal foreign bodies of button battery
- Keywords:
- Esophagus; Foreign Bodies; Treatment Outcome; Child
- CLC:
- R768.3+2;R655.4;R571+.1
- Abstract:
- Objective To explore the complications and outcomes of children with esophageal foreign body of button battery. Methods Retrospective analysis was conducted for the clinical data of 22 children hospitalized with esophageal foreign bodies of button battery from January 2013 to January 2019. There were 12 boys and 10 girls with a median age of 30.5 months. The presenting symptoms included dysphagia (n=19), vomiting (n=17), salivation (n=5) and nausea (n=1). The length of disease course was 2 hours to 6 months. And the indwelling time of foreign body was <6 h (n=6), 6-24 h (n=5), 24-48 h (n=3) and ≥ 48 h (n=8). The impaction sites were upper (n=14), middle (n=3) and lower (n=5) esophagus. Results The complications were esophageal mucosal erosion (n=21), esophageal inflammation (n=12), esophageal perforation with tracheal esophageal fistula (n=3), esophageal stricture (n=2), esophageal stenosis (n=2) and hemorrhage (n=1). The outcomes were cure (n=19), discharge after improvement (n=2) and death (n=1). One case of esophageal perforation naturally healed after strengthening nutrition and infection control. Another one was discharged after thoracic surgery for repairing esophageal perforation. One case of tracheal esophageal fistula was operated at another hospital while another one was still under follow-ups. Two cases of esophageal stenosis underwent esophageal dilation while another one was still under observations. One mortality occurred due to massive hemorrhage. Conclusion Foreign body of button battery causes great damage to esophageal wall and whole body. Medical care should be sought as soon as possible. Prompt and effective treatments, strengthening observations and regular follow-ups after discharge may reduce the incidence rate of complications and improve the outcomes.
References:
1 僧东杰,李颖,徐艳霞,等.小儿特殊类型食管异物取出术及其并发症的处理[J].中国小儿急救医学,2017,24(7):1673-4912.DOI:10.3760/cma.j.issn.1673-4912.2017.07.017. Seng DJ,Li Y,Xu YX,et al.Removal of special types of esophageal foreign body in children and its complications[J].Chin J Pediatr Emerg Med,2017,24(7):1673-4912.DOI:10.3760/cma.j.issn.1673-4912.2017.07.017.
2 Sugawa C,Ono H,Taleb M,et al.Endoscopic management of foreign bodies in the upper gastrointestinal tract:A review[J].World J Gastrointest Endosc,2014,6(10):475-481.DOI:10.4253/wjge.v6.i10.475.
3 Lee JH,Lee JH,Shim JO,et al.Foreign body ingestion in children:should button batteries in the stomach be urgently removed?[J].Pediatr Gastroenterol Hepatol Nutr,2016,19(1):20-28.DOI:10.5223/pghn.2016.19.1.20.
4 孔维佳.耳鼻咽喉头颈外科学[M].北京:人民卫生出版社,2008:564-566. Kong WJ.Otorhinolaryngology-Head and Neck Surgery[M].Beijing:People’s Medical Publishing House,2008:564-566.
5 Betalli P,Rossi A,Bini M,et al.Update on management of caustic and foreign body ingestion in children[J].Diagn Ther Endosc,2009,2009:969868.DOI:10.1155/2009/969868.
6 Lee JH,Lee JH,Shim JO,et al.Foreign body ingestion in children:should button batteries in the stomach be urgently removed?[J].Pediatr Gastroenterol Hepatol Nutrn,2016,19(1):20-28.DOI:10.5223/pghn.2016.19.1.20.
7 Alan E,Mourad M,Akers,et al.A case of battery ingestion in a pediatric patient:what is its importance?[J].Case Rep Pediatr,2015,2015:345050.DOI:10.1155/2015/345050.
8 敬云龙,赵斯君,黄敏,等.食道异物钳在大型气管、支气管异物取出术中的应用[J].临床小儿外科杂志,2017,16(4):373-375,394.DOI:10.3969/j.issn.1671-6353.2017.04.014. Jing YL,Zhao SJ,Huang M,et al.Application of esophageal foreign body forceps in extracting large tracheal and bronchial foreign bodies[J].J Clin Ped Sur,2017,16(4):373-375,394.DOI:10.3969/j.issn.1671-6353.2017.04.014.
9 Litovitz T,Whitaker N,Clark L,et al.Emerging battery-ingestion hazard:clinical implications[J].Pediatr,2010,125(6):1168-1177.DOI:10.1542/peds.2009-3037.
10 Hamilton JM,Schraff SA,Notrica DM.Severe injuries from coin cell battery ingestions:2 case reports[J].J Pediatr Surg,2009,44(3):644-647.DOI:10.1016/j.jpedsurg.2008.10.110.
11 张亚梅,张天宇.实用小儿耳鼻咽喉科学[M].北京:人民卫生出版社,2011:424-427. Zhang YM,Zhang TY.Practical Pediatric Otolaryngology[M].Beijing:People’s Medical Publishing House,2011:424-427.
12 马玉强,刘海霞,马敏,等.儿童纽扣式电池食管异物分析[J].中国耳鼻咽喉头颈外科,2017,12(12):641-643.DOI:10.16066/j.1672-7002.2017.12.010. Ma YQ,Liu HX,Ma M,et al.Button battery foreign body in esophagus in children:An analysis of 12 cases[J].Chin Arch Otorhinolaryngol Head Neck Surg,2017,12(12):641-643.DOI:10.16066/j.1672-7002.2017.12.010.
13 赵斯君,李赟,黄敏,等.鼻腔纽扣电池异物38例[J].临床小儿外科杂志,2011,10(6):438-439.DOI:10.3969/j.issn.1671-6353.2011.06.013. Zhao SJ,Li Y,Huang M,et al.38 cases of nasal button battery foreign body[J].J Clin Pedc Sur,2011,10(6):438-439.DOI:10.3969/j.issn.1671-6353.2011.06.013.
14 Fuentes S,Cano I,Benavent MI,et al.Severe esophageal injuries caused by accidental button battery ingestion in children[J].J Emerg Trauma Shock,2014,7(4):316-321.DOI:10.4103/0974-2700.142773.
15 Mcconnell MK.When button batteries become breakfast:the hidden dangers of button battery ingestion[J].J Pediatr Nurs,2013,28(6):e42-e49.DOI:10.1016/j.pedn.2012.12.008.
16 程伟伟,刘海峰,胡志红,等.内镜诊治儿童电池类消化道异物临床分析[J].中国小儿急救医学,2015,22(12):840-843.DOI:10.3760/cma.j.issn.1673-4912.2015.12.008. Cheng WW,Liu HF,Hu ZH,et al.Endoscopic diagnosis and treatment of children foreign bodies of battery in digestive tract:analysis of 13 cases[J].Chin Pediatr Emerg Med,2015,22(12):840-843.DOI:10.3760/cma.j.issn.1673-4912.2015.12.008.
Memo
收稿日期:2019-04-30。
基金项目:湖南省自然科学基金（编号：2019JJ80043）
通讯作者:罗欣友,Email:Luoxinyou 1972@sina.com