Endoscopic Findings and Correlation with Outcome in Oesophagal Battery Button Ingestion in Children

Abstract

Objective: To determine the endoscopic findings and its correlation with outcome in oesophageal battery button ingestion in children. Study Design: Cross sectional study. Place and duration of study: Department of Paediatric Gastroenterology, Hepatology, Children’s Hospital and University of Child Health Sciences, Lahore Pakistan, from Jul 2021 to Jun 2022. Methodology: We recruited children with button battery ingestion over a period of one year. Data of the patients’ demographics, symptoms, time from ingestion to admission, oesophagal location and size of the battery, grade of mucosal injury, management, complications, and follow-up outcome were recorded. Results: Forty-one children with a mean age of 3.6±1.76 years (range: 1-9 years) were enrolled over one year. The most common site of battery impaction was the lower end of the oesophagus (22, 53.7%). The median time from ingestion to admission was 7.2 hours, with vomiting and chest pain being the most common admission symptoms noted in 24 (58.5%) cases. According to Zargar’s classification, Grade II mucosal injury was most frequent in 21 (51.2%) patients, followed by Grade III in 11 (26.8%) children, and 9 (22%) cases developed oesophagal strictures later on. Regarding the size of the battery, we could measure the diameter, and the median was 18.0 mm (range, 18–20 mm). Three patients had severe complications other than strictures, in one case each (2.4%), and these children could not survive and died due to complications of fistulas and massive bleeding. Conclusion: Button-battery ingestion is a frequently noticed problem in developing countries like Pakistan. Immediate recognition and endos

Keywords

• Tracheoesophageal fistula
• Esophageal perforations
• Esophageal-aortal fistulas