BATTERY INGESTION COMPLICATIONS IN CHILDREN: CASE SERIES

Aims:

Accidental ingestion of foreign bodies is common in children and is a medical emergency when it comes to battery intakes. According to data from a study conducted in the USA in the period 1986 – 2009, 56,535 cases of ingestion of batteries were recorded. It is important to note that 90% are asymptomatic or present with sialorrhea, dysphagia, food refusal, vomiting, hematemesis, cough, hematochezia, peritonitis and mediastinitis. The diagnosis is based on anamnesis and imaging tests. The main complications are tracheoesophageal fistula, esophageal perforation, esophageal stricture and death.

Methods:

Six patients were treated with complications resulting from battery impaction in the esophagus and were followed up at the Hospital Felício Rocho, the Hospital João Paulo II and João XXIII in Belo Horizonte, Brazil from January 2009 to March 2018. All of them presented severe complications secondary to the impaction of the battery in the esophagus and were followed up until hospital discharge. The patient's complications were: patient 1: perforation of the esophagus, mediastinitis and pneumothorax/pneumomediastinum; patient 2: esophagomediastinal fistula; patient 3, 4 and 5: esophageal ulcer and esophageal stenosis; and patient 6: esophagotracheal fistula and mediastinitis.

Results:

Three patients evolved with esophageal stenosis and dilations were performed, with good evolution in all. One patient evolved with esophageal stenosis and esophagomediastinal fistula with conservative treatment. One patient required cervical esophagostomy, gastrostomy and awaiting esophageal reconstruction. One patient underwent tracheostomy, gastrostomy, jejunostomy and closure of esophagotracheal fistula.

Conclusions:

The impaction of batteries in the esophagus is a medical emergency and its prevention is very important, mainly by the parents, since all the accidents happen in their homes.