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

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 es...

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Autores principales: Shibuya, Soichi, Azuma, Takahiro, Lane, Geoffrey J., Okawada, Manabu, Yamataka, Atsuyuki
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Georg Thieme Verlag KG 2020
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7156279/
https://www.ncbi.nlm.nih.gov/pubmed/32550120
http://dx.doi.org/10.1055/s-0040-1705157
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author Shibuya, Soichi
Azuma, Takahiro
Lane, Geoffrey J.
Okawada, Manabu
Yamataka, Atsuyuki
author_facet Shibuya, Soichi
Azuma, Takahiro
Lane, Geoffrey J.
Okawada, Manabu
Yamataka, Atsuyuki
author_sort Shibuya, Soichi
collection PubMed
description 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.
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spelling pubmed-71562792020-06-16 Successful Strategy for the Conservative Management of Acquired Tracheoesophageal Fistula Due to Lithium Button Battery Ingestion Shibuya, Soichi Azuma, Takahiro Lane, Geoffrey J. Okawada, Manabu Yamataka, Atsuyuki European J Pediatr Surg Rep 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. Georg Thieme Verlag KG 2020-01 2020-04-14 /pmc/articles/PMC7156279/ /pubmed/32550120 http://dx.doi.org/10.1055/s-0040-1705157 Text en https://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Shibuya, Soichi
Azuma, Takahiro
Lane, Geoffrey J.
Okawada, Manabu
Yamataka, Atsuyuki
Successful Strategy for the Conservative Management of Acquired Tracheoesophageal Fistula Due to Lithium Button Battery Ingestion
title Successful Strategy for the Conservative Management of Acquired Tracheoesophageal Fistula Due to Lithium Button Battery Ingestion
title_full Successful Strategy for the Conservative Management of Acquired Tracheoesophageal Fistula Due to Lithium Button Battery Ingestion
title_fullStr Successful Strategy for the Conservative Management of Acquired Tracheoesophageal Fistula Due to Lithium Button Battery Ingestion
title_full_unstemmed Successful Strategy for the Conservative Management of Acquired Tracheoesophageal Fistula Due to Lithium Button Battery Ingestion
title_short Successful Strategy for the Conservative Management of Acquired Tracheoesophageal Fistula Due to Lithium Button Battery Ingestion
title_sort successful strategy for the conservative management of acquired tracheoesophageal fistula due to lithium button battery ingestion
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7156279/
https://www.ncbi.nlm.nih.gov/pubmed/32550120
http://dx.doi.org/10.1055/s-0040-1705157
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