ABSTRACT
INTRODUCTION: Button batteries represent a low percentage of all foreign bodies swallowed by children and esophageal location is even less frequent. However, these cases are more likely to develop severe injuries. The aim of this essay is to report three cases treated in our institution and review previous reports. MATERIAL AND METHODS: Chart review and literature search. CASE REPORTS: We treated three children between 2-7- years old with button batteries lodged at esophagus. They all presented esophageal burns (EB), which evolved in esophageal stenosis in two out of the three cases. RESULTS: We found 29 more cases in literature and the injuries included EB, esophageal perforation (EP) and tracheoesophageal fistula (TEF). DISCUSSION: Swallowed button batteries rarely remain in esophagus, but these cases present a higher risk of tisular damage. Injuries can take place even after few hours; and therefore, endoscopy must be performed as soon as possible. Further study on button batteries' safety and the establishment of a maximum size for them would be good preventive measures.
ABSTRACT
OBJECTIVES: This study focuses on the different surgical and endoscopical treatment alternatives when dealing with severe complications after slide tracheoplasty (STP). METHODS: Retrospective study of patients with symptomatic congenital tracheal stenosis (CTS) admitted to a single institution, between January 1997 and January 2013, surgically treated by means of STP. The following variables were evaluated: demographics, preoperative tracheal stenosis characteristics, associated anomalies and outcome measures. RESULTS: Cohort included 14 patients (8 males and 6 females) with a mean age of 8.7 months when treated (range, 1-43 m). Eleven patients (78%) showed a long segment CTS (>30% of total tracheal length) and 9 (64%) had associated cardiac or great vessel anomalies (left pulmonary artery sling). Three patients (21%) showed severe postoperative complications that required significant airway reintervention: tracheal resection of a restenotic segment, laser division with balloon dilatation of a residual stenosis and placement of a biodegradable endotracheal stent in an extensive tracheal narrowing. All patients are in good clinical condition with a mean follow-up of 6.3 years (range, 2 months to 16 years). CONCLUSIONS: STP has become the procedure of choice when dealing with CTS. Although it shows clear advantages compared with other surgical techniques, severe and difficult to manage complications may occur. Surgeons involved in their treatment should be familiar with diverse surgical and endoscopical procedures. Biodegradable airway stenting is a new and promising technique when long and severe post-surgical tracheal stenosis is present.
