Esophageal impaction of button batteries in childhood. how to avoid tragedy!
Martínez-Criado, Y.; Millán López, A.; Valladares, J.C.; De Agustín Asensio, J.C.
Cirugia Pediatrica Organo Oficial de la Sociedad Espanola de Cirugia Pediatrica 26(3): 142-145
2013
ISSN/ISBN: 0214-1221 PMID: 24482908 Document Number: 669332
Ingestion of button batteries (PB) represents less than 2% of all foreign bodies, but its incidence is increasing. Esophageal impaction produces severe damages, which can be devastating. Our aim is to present 3 new cases and the therapeutic protocol followed in our center. We report 3 children who presented esophageal foreign body impaction, displaying a PB with the "double halo sign" on the radiograph, being situated in the upper, medium and low esophageal in each case. The protocol followed included: radiography of the neck, chest and abdomen; high doses of corticosteroids, inhibitors of proton pump, antibiotics and urgent endoscopy removal. A nasogastric tube was placed in the same act. The PB had been impacted for 10.3 hours (5-14) but had inflammation and necrosis of the esophageal mucosa. We applied the specified protocol. Oral feeding was initiated 8 +/- 2 days after with a normal esophagogastric study, which was repeated a month later to exclude stenosis. Adherence to a diagnostic and therapeutic protocol prevents the complications of esophageal impaction of button batteries. We consider the double halo image pathognomonic of the PB.