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CC BY 4.0 · European J Pediatr Surg Rep. 2020; 08(01): e18-e22
DOI: 10.1055/s-0040-1705157
Case Report
Georg Thieme Verlag KG Stuttgart · New York

Successful Strategy for the Conservative Management of Acquired Tracheoesophageal Fistula Due to Lithium Button Battery Ingestion

Soichi Shibuya
1   Department of Pediatric General and Urogenital Surgery, Juntendo University, Tokyo, Japan
,
Takahiro Azuma
1   Department of Pediatric General and Urogenital Surgery, Juntendo University, Tokyo, Japan
,
Geoffrey J. Lane
1   Department of Pediatric General and Urogenital Surgery, Juntendo University, Tokyo, Japan
,
Manabu Okawada
1   Department of Pediatric General and Urogenital Surgery, Juntendo University, Tokyo, Japan
,
Atsuyuki Yamataka
1   Department of Pediatric General and Urogenital Surgery, Juntendo University, Tokyo, Japan
› Author Affiliations
Further Information

Publication History

09 July 2019
15 May 2019

10 January 2010

Publication Date:
14 April 2020 (online)

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Abstract

A 16-month-old boy was referred to our hospital for the management of suspected lithium button battery (LBB) ingestion. He had been previously well, but became febrile with a persistent cough resistant to oral antibiotics and dysphagia for 5 days. Radiography identified an LBB lodged in the upper esophagus. The LBB was retrieved under direct visualization with rigid laryngoscopy. He was sedated for 5 days and enteral feeding was commenced through a nasojejunal tube on the next day after procedure. On day 8 after retrieval, endoscopy and fluoroscopy identified a tracheoesophageal fistula (TEF), 6 mm in diameter. Conservative management was conducted with periodic follow-up endoscopies, which showed signs of healing in the esophagus. Following continuous antibiotics and proactive nutritional support, the TEF was found to have closed spontaneously by day 28 after the LBB removal. We present our experience of the successful nonsurgical management of acquired TEF secondary to LBB ingestion and aim to establish a protocol for managing it conservatively by reviewing the relevant literature.

Keywords

foreign body ingestions - tracheoesophageal fistula - conservative treatment - lithium button battery - mediastinitis
 

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