Journal of Pediatric Gastroenterology & Nutrition:
ABSTRACTS: Poster Session Abstracts
Chang, Y. J.1; Chen, S. Y.1; Chao, H. C.1; Lai, M. W.1; Kong, M. S.1
1Division of pediatric gastroenterology and hepatology, Chang Gung Children’s Hospital, Taoyuan, Taiwan
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Introduction: To study the characteristics, outcome, and manegement of disc battery ingestion in children
Methods: We reviewed a 5-year record of children under 15 years old admitted to Chang Gung Children Hospital with disc battery ingestion from September 1997 to July 2003.The diagnosis of disc battery ingestion was based upon history, clinical symptoms and imaging studies. The clinical data reviewed included sex, age, clinical manifestation, hospital course, imaging findings, and endoscopic results.
Results: There were twelve cases (8 males and 4 females) with mean age 1.9 +/− 3.43 years (range, 9 months–5 years). Two patients (16%) had symptoms of vomiting, nausea, and abdominal pain. Two cases (16%) had no history of disc battery ingestion and were accidentally found by X ray studies. Four cases (33 %) had their battery impacted in esophagus and eight cases (67 %) was in stomach. Except for the patient who died suddently, three of the patinets with esophageal foreign bodies were removed sucessfully by endoscopy. For the patients with battery in the stomach, one case (12%) underwent endoscopic removal and the other had the battery spontaneously passed through the gastrointestinal tract within 5days.The diameter of ingested disc battery ranged from 12mm to 23mm. The battery diamter which larger then 2cm are easily impacted in esophagus.The durationof hositalization were from 1 day to 61 days (esophagus mean 21 days, stomach mean 1.25days). There were five patients with complications, three had esophageal mucosa damage(erosion or necorsis), one had gastric mucosa erosion and hemorrhage. One patient with esophageal damage developed tracheoesophageal fistula, and one case was complicated with sudden death.
Conclusion: Most disc battery misswallowing runs an uneventful course.
However, it may be fatal or with serious complications if the battery impacted in esophagus. The larger battery diamter or unknown hisotry with accidental finding are the risk facotr of complications. Emergency endoscopic management and closely follow up was necessay if the disc battery was found in esophagus. Once in stomach, the battery will usually pass through the gastrointestinal tract without difficulty
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