Evaluation of a Symptom-Based Algorithm for Managing Battery Ingestions in Children
| Autor: | James A. Fraser, Kayla B. Briggs, Wendy Jo Svetanoff, Thomas M. Attard, Tolulope A. Oyetunji, Shawn D. St Peter |
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| Rok vydání: | 2021 |
| Předmět: | |
| Zdroj: | European Journal of Pediatric Surgery. 32:002-008 |
| ISSN: | 1439-359X 0939-7248 |
| Popis: | Objectives While complications from battery ingestion can be severe, especially with the emergence of stronger battery elements, not all ingestions require prompt removal. We aim to evaluate a symptom-focused algorithm for battery ingestion that emphasizes observation over intervention to investigate its safety. Materials and Methods Patients were identified through a query of foreign-body ingestion radiographs obtained between 2017 and 2020. A retrospective chart review was then performed of all patients who presented with button battery ingestions to identify compliance with our algorithm, overall outcomes, and complications. Results In total, 2% of all radiographs (44/2,237) demonstrated button battery ingestions. The median age of patients was 3.8 years (interquartile range, 2.6–5.3). Most batteries were found in the stomach (64%, n = 28), but were also identified in the esophagus (14%, n = 6), small bowel (14%, n = 6), and colon (9%, n = 4). All esophageal batteries were managed with immediate endoscopic retrieval. Ten gastric batteries were not managed per protocol, with seven admitted for observation despite being asymptomatic and repeat abdominal X-rays demonstrating persistent gastric location of the battery. Four patients underwent esophagogastroduodenoscopy; however, in two patients the battery had migrated past the stomach prior to intervention. All small bowel batteries and three of four asymptomatic colon batteries were managed per protocol; one patient had additional imaging that demonstrated battery passage. Conclusion Adherence to a symptom-focused protocol for conservative management of button battery ingestions beyond the gastroesophageal junction is safe and frequently does not require admission, serial imaging, or intervention. |
| Databáze: | OpenAIRE |
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