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Epistaxis in children is one of the most common referral dealt by an ENT outpatient department . Here we report a case of a 2-year-old girl who presented with complaints of recurrent episodes of epistaxis and discharge from the right nasal cavity since 1 month duration. Endoscopic examination of the right side of nose revealed a button battery impacted between the inferior turbinate and the cartilaginous portion of nasal septum
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Objective:To analyze the clinical characteristics, endoscopic manifestations, complications and related risk factors of button battery ingestion in 58 children, thus providing the basis for clinical diagnosis and treatment.Methods:The medical data of 58 children with button battery ingestion were collected and researched at Children′s Hospital Affiliated to Zhengzhou University from September 2015 to September 2020.The demographic information, battery impaction location, duration, symptoms, mucosal injury level, battery size, treatment, complications and follow-up results were analyzed.Results:The average age of the patients with button battery ingestion was (25.7±15.4)months, including 40 boys(68.9%). The average retention time of the battery in digestive tract was 13.8(2, 96) h. Vomiting, salivation, dysphagia, cough and fever were the common chief complaints.There were 29(50.0%) cases of grade I mucosal injury, as well as 14(24.1%) cases, 10(17.2%) cases and 10(17.2%) cases for grade Ⅱ, grade Ⅲ and grade Ⅳ, respectively.Additionally, common complications included esophageal stenosis, esophageal perforation and esophageal-tracheal fistula.Logistic regression analysis showed that location(esophagus) and diameter(≥15 mm) of battery incarceration were important predictors of complications.Conclusion:The degree of mucosal damage is associated with the diameter and impaction location of battery.The button battery embedded in the esophagus is prone to complications, while the ones retained in the stomach were not vulnerable to serious complications.Endoscopy and other related examinations should be performed again in 1 to 3 weeks after the button removal to determine the outcome of complications and to intervene in time.
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Foreign body ingestion is common among children between the ages of 6 months and 3 years. Nearly 80% will pass throughuneventfully and 20% will require some intervention, mostly endoscopic removal. Button batteries and magnets are frequentcomponents of children’s toys and a potential hazard for the child. We are reporting such a case and the complications whichfollowed, with a view to increasing public awareness.
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Objective To study the clinical characteristics and treatment of esophageal injury caused by button battery foreign bodies in children, then improve the diagnosis and management level of this hazardous problem of children. Methods 15 patients with esophageal injury caused by button battery foreign bodies were retrospectively analyzed the clinical characteristics, treatment and prognosis. Results 12 button battery foreign bodies were removed successfully with rigid esophagoscope, 3 with electronic gastroscope. 12 cases occurred serious esophageal lesions, 10 patients were fully recovered after nasal feeding, anti-inflammatory and supporting therapy. Serious complication such as esophageal perforation occurred in 2 cases, one of them occurred tracheo-esophageal fistula. Conclusion Button battery embedded in the esophagus is easy to cause serious esophagus injury, early detection is the key of the management, and its prompt removal is mandatory. Button battery have a distinctive appearance on radiography, chest radiographs can be used as the first choice of diagnosis. The reasonable treatment can obtain better curative results and avoid serious complications according to the course of the disease and esophageal damage degree. Physicians must recognize the hazardous potential and serious implications such as esophageal perforation and tracheo-esophageal fistula.
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In most cases of ingested foreign bodies, endoscopy is the first treatment of choice. Moreover, emergency endoscopic removal is required for sharp and pointed foreign bodies such as animal or fish bones, food boluses, and button batteries due to the increased risks of perforation, obstruction, and bleeding. Here, we presented two cases that needed emergency endoscopic removal of foreign bodies without sufficient fasting time. Foreign bodies could not be visualized by endoscopy due to food residue; therefore, fluoroscopic imaging was utilized for endoscopic removal of foreign bodies in both cases.
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Animals , Emergencies , Endoscopy , Fasting , Fluoroscopy , Foreign Bodies , HemorrhageABSTRACT
Ingestion of foreign body in children is a relatively common problem among paediatric population. The foreign bodies mostly pass spontaneously through the gastrointestinal tract. However, complications can occur according to its anatomical location, the characteristics of the foreign body, and delays in management. Although the cases of ingested button batteries or sharp objects impacted at the gastrointestinal tract can be very serious, there have been very only a few cases have reported colonoscopic removal of these dangerous foreign bodies in adults, and there have been no case reports in children. We report one case of a button battery and one case of an open safety pin, both impacted in the terminal ileum that had moved from the stomach within a few hours of ingestion and were eventually managed by colonoscopy without any complications.
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Adult , Child , Humans , Colonoscopy , Eating , Foreign Bodies , Gastrointestinal Tract , Ileum , StomachABSTRACT
PURPOSE: Foreign body (FB) ingestion is common in children, and button battery (BB) ingestion has been increasing in recent years. This study was to identify factors related to outcomes of FB ingestion, particularly BBs in the stomach. We evaluated whether the current recommendations are appropriate and aimed to suggest indications for endoscopic removal of BB in the stomach in young children. METHODS: We investigated patient age, shape, size, location of FBs, spontaneous passage time and resulting complications among 76 children. We observed types, size, location of BB and outcomes, and analyzed their associations with complications. RESULTS: Coins and BB were the two most common FBs. Their shapes and sizes were not associated with the spontaneous passage time. Size, spontaneous passage time, and age were also not associated with any specific complications. For BB ingestion, all 5 cases with lithium batteries (≥1.5 cm, 3 V) presented moderate to major complications in the esophagus and stomach without any symptoms, even when the batteries were in the stomach and beyond the duodenum, while no complications were noted in 7 cases with alkaline batteries (<1.5 cm, 1.5 V) (p=0.001). All endoscopies were conducted within 24 hours after ingestion. CONCLUSION: The type and voltage of the battery should be considered when determining whether endoscopy is required to remove a BB in the stomach. For lithium battery ingestion in young children, urgent endoscopic removal might be important in order to prevent complications, even if the child is asymptomatic and the battery is smaller than 2 cm.
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Child , Humans , Duodenum , Eating , Endoscopy , Esophagus , Foreign Bodies , Lithium , Numismatics , StomachABSTRACT
Aims: To report to cases of button batteries as nasal foreign bodies and to emphasize the unique clinical characteristics of this condition regarding diagnosis and management. Presentation of Case: We report two boys, one 5-year-old who was found to have a button battery in his left nasal cavity for a long time and subsequently developed a septal perforation and a 4-year-old in whom the quick removal of the battery from his nose resulted in an uneventful fast recovery. Discussion and Conclusion: The etiology of septal perforation is presented briefly. The mechanism and management of button battery injury are discussed. The time interval between insertion and removal, the battery’s anode orientation and its thickness were the most important factors identified. The previous two cases highlight the management peculiarities of these rarely described foreign nasal bodies. Early removal and treatment, including antibiotics and nasal toilet, appears to offer the best prognosis.
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Foreign body management is an important aspect in the practice of a general practitioner1. In Singapore, the most common foreign body we encounter would be fishbone. This is not surprising as steamed fish is a common dish in our Asian diet. In spite of the rapid advances in medical technology, a good history taking and physical examination remain the most important step in helping us clinch a diagnosis. In this article, we will focus on the common foreign bodies seen in the Ear, Nose and Throat area as a general practitioner, and the tips and pearls in the examination and management. In each section, there will also be some tips on the red flags to look out for and when a tertiary referral should be made.
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With the wide use of button battery in everyday life, the risk associated with its use is also increasing. Mechanical pressure, chemical and electrical burn caused by button battery in the nasal cavity result in necrosis. Prolonged presence of button battery in the nasal cavity may also incur serious side effects of cosmetic nature, including saddle nose. Thus prompt diagnosis and treatment is important when button battery is detected in the nasal cavity. We present two cases of button battery in the nasal cavity with review of literatures.
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Burns , Diagnosis , Foreign Bodies , Nasal Cavity , Necrosis , NoseABSTRACT
La ingestión de cuerpos extraños es un accidente evitable que se observa principalmente en niños menores de 3 años. La mayoría de ellos atraviesan el tubo digestivo sin ocasionar manifestaciones clínicas ni complicaciones; sin embargo, un porcentaje significativo se impacta en el esófago y causa vómitos, odinofagia, disfagia y sialorrea. Los cuerpos extraños más frecuentes son las monedas. Las complicaciones ocurren por lo general cuando se demora el diagnóstico o se trata de objetos grandes, afilados o potencialmente tóxicos, como la pila botón. Es fundamental realizar el diagnóstico diferencial entre una moneda y una pila botón, ya que esta última requiere su extracción urgente debido a la precocidad de las lesiones que produce. Se describen 115 casos de cuerpos extraños en el esófago. Se subraya la importancia de realizar un diagnóstico y tratamiento oportunos, así como de asesorar a los padres para la prevención.
Ingestion of foreign bodies is an avoidable accident that is seen mainly in children under 3 years-old. Most of them pass through the digestive tract without causing clinical manifestations or complications, but a significant percentage is impacted in the esophagus causing vomiting, sore throat, dysphagia and drooling. The most common foreign bodies are coins. Complications usually occur when there is a delay in diagnosis or with large, sharp or potentially toxic objects, as the button battery. It is essential to make differential diagnosis between coin and button battery, since the latter requires urgent removal due to the earliness of the injury caused. We report 115 cases of foreign bodies in the esophagus, and we alert the pediatrician in recognizing and preventing this problem.
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Adolescent , Child , Child, Preschool , Female , Humans , Infant , Male , Esophagus , Foreign Bodies , Foreign Bodies/complications , Foreign Bodies/therapyABSTRACT
We describe a case of corrosive tracheo-esophageal fistula following button battery ingestion in a 1-year old nonverbal pediatric patient. The delay in diagnosis was caused by failure to obtain correct history and failure to detect opacity of the battery in the neck at the first visit. The large fistula was successfully treated with division and repair with non absorbable sutures, with interposition of strap muscles between separated trachea and esophagus.
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A button battery in the nose of children is an unusual foreign body, which can cause liquefaction necrosis with subsequent severe local tissue destruction. All button batteries as foreign bodies in the nasal cavity should be removed immediately to prevent severe local tissue damage, resulting in late sequelae, such as septal perforation or stenosis of the nasal meatus. We present two cases of nasal septal perforation followed by button battery foreign body and discuss the special aspects of this foreign body.
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Child , Humans , Constriction, Pathologic , Foreign Bodies , Nasal Cavity , Nasal Septal Perforation , Necrosis , NoseABSTRACT
A button battery in the nose of children is an unusual foreign body, which can cause liquefaction necrosis with subsequent severe local tissue destruction. All button batteries as foreign bodies in the nasal cavity should be removed immediately to prevent severe local tissue damage, resulting in late sequelae, such as septal perforation or stenosis of the nasal meatus. We present two cases of nasal septal perforation followed by button battery foreign body and discuss the special aspects of this foreign body.