|LETTER TO EDITOR
|Year : 2020 | Volume
| Issue : 2 | Page : 110-111
Corrosive esophageal injury caused by impacted button battery
Charulatha Ravindran, Sripriya R., Gobinath Jayaraman
Department of Anaesthesiology & Critical Care, Mahatma Gandhi Medical College and Research Institute (MGMCRI), Sri Balaji Vidyapeeth (Deemed University), Puducherry, India
|Date of Submission||26-Oct-2019|
|Date of Acceptance||12-Apr-2020|
|Date of Web Publication||10-Sep-2020|
Dr. Charulatha Ravindran
MD, Assistant Professor, Department of Anaesthesiology & Critical Care, Mahatma Gandhi Medical College and Research Institute (MGMCRI), Sri Balaji Vidyapeeth (Deemed University), Puducherry 607403
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Ravindran C, R. S, Jayaraman G. Corrosive esophageal injury caused by impacted button battery. J Assoc Chest Physicians 2020;8:110-1
Button batteries larger than 20 mm when ingested by toddlers get impacted in the narrow esophagus causing significant injury to the upper aerodigestive tract. The button battery in the above image was recovered from a two year old child, who had presented with drooling of saliva and refusal of feeds for the past two days. [Figure 1]A shows the button battery with negative pole facing anteriorly and a retropharyngeal abscess secondary to the foreign body. Impaction of the battery more than 48 hours had caused deep erosive ulcerations in the esophageal mucosa [Figure 1]B due to electrolysis and alkaline caustic injury. 1 Though the battery was identified in the upper esophagus [Figure 1]A, induction of anaesthesia had caused the battery to migrate into the stomach. The battery was recovered from the stomach and during its short transit time, had caused superficial ulcers in lower esophagus. The battery was removed by endoscopy under general anaesthesia and the postoperative period was uneventful. Barium swallow did not reveal any fistula due to the corrosive injury.
|Figure 1 A X ray of the child in lateral view showing the button battery and retropharyngeal abscess, B endoscopy image of the upper esophagus showing deep corrosive injuries due to impacted button battery. Inset image – Button battery after removal.|
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Diagnosis of button battery ingestion in less than five years old children is an emergency and activation of an emergency protocol similar to trauma management is required. Children are usually not in the fasting state and rapid sequence induction is necessary. Care should be taken to prevent obstruction or displacement of endotracheal tube by the endoscope. Nasogastric tube insertion should be avoided to prevent injury to the friable mucosa. Recent guidelines recommend irrigation with dilute acids to counteract the caustic injury. Children may require anaesthesia for repeat endoscopy or pertinent imaging to identify complications like fistulae or vascular erosions.
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Conflicts of interest
There are no conflicts of interest.
| References|| |
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