Esophageal Inflammatory Fibroid Polyp After Button Battery Ingestion

Abstract

A 2-year-old male presented to an outside facility with 8-days of decreased intake. Chest X-ray (CXR) revealed a radiopaque object in the upper esophagus suspicious for a battery. The patient was taken for an urgent rigid esophagoscope, no honey or sucralfate was given pre-procedure. Following removal, the posterior mucosal wall was charred with mucosal erosion. No acetic acid irrigation was recorded. The patient was discharged the following day after a normal CXR but no computed tomography (CT) scan. Two months post-removal, the patient was evaluated for recurrent vomiting. Esophagogram showed narrowing in the proximal esophagus and filling defect suspicious for scar tissue or foreign body (Fig. 1). Endoscopy 57 days after initial procedure demonstrated stenosis at the site of prior injury and a 2-cm polyp occluding the lumen (Fig. 2). Hot snare removal was successful, dilation was deferred due to perforation risk. Pathology was consistent with an inflammatory fibroid polyp. Endoscopy 76 days later, showed healed polypectomy site and mild narrowing, which was dilated. Button battery ingestion carries significant risk of morbidity and mortality (1-4). Complications of tissue necrosis, fistula formation, stenosis and perforation are well documented; fibrous polyp formation has not been described (3,4). This case highlights the importance of risk mitigating strategies as described in recent guidelines (1,3,5).

Secondary esophageal perforation rupture of ascending aorta 16 day accidently-swallowing button battery in a young child: A case report of esophagial foreign body and mini review

“…Although the button battery was taken out after being swallowed by mistake, due to the lack of clinical experience in its treatment, the severity of the later complications was not fully estimated, leading to the failure to prevent the death of the child. Through this report a recurrence of the similar cases was expected to be avoided [1] , [2] , [3] . This case report has been reported in line with the SCARE Criteria [4] .…”

“…The corrosion does not stop immediately Even if the battery is removed, it will continue to develop and result in mucosal erosion, ulceration, and even perforation in severe cases. In this case, the child was hospitalized without abnormality for 10 days after the button battery removed, while esophageal perforation occurred after discharge, which is precisely the mechanism of injury caused by the above [2] , [5] .…”