Repair of tracheo-oesophageal fistula secondary to button battery ingestion: A combined cervical and median sternotomy approach

“…Non-intervention management should first be tried to manage tracheoesophageal fistulas acquired in children [26]. Gopal et al (2015) reported a case in which a three-year-old child developed a large tracheoesophageal fistula for 36 h due to the placement of a button battery. Surgical access was obtained through right cervical incision and median sternotomy.…”

Section: Discussionmentioning

confidence: 99%

“…Tracheoesophageal fistulas (TEF) may be complicated by the high incidence of comorbidities such as recurrent laryngeal nerve injury, tracheal stenosis, recurrent fistula, or even mortality. Studies of medical records of children with vocal cord paralysis and esophageal lithium battery ingestion have shown that it may cause serious complications such as esophageal perforation, mediastinal infection, tracheal fistula, vocal cord paralysis, and life-threatening bleeding [4][5][6]. In a study, a 16-month-old boy with lithium battery ingestion developed bilateral voice paralysis due to misdiagnosis.…”

Section: Introductionmentioning

confidence: 99%

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2022

J. Med. Chem. Sci.

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Bilateral vocal cord paralysis is one of the most dangerous electrochemical burns caused by lithium battery ingestion, especially in children. Current treatments usually include immediate battery removal to a range of conservative management techniques and invasive procedures, including tracheostomy, unilateral posterior cordotomy, thoracotomy, and other surgical procedures. This study reports a two-year-old girl with laryngeal electrochemical tissue burn and bilateral vocal cord paralysis due to lithium battery ingestion. She was treated by low-level laser therapy (LLLT) by TecmLP200, for Red Light Laser (650 nm) and Infrared Laser (810nm100 mw) on necks acupoint and some other points. The use of LLLT has been quite successful in treating the effects of ingestion of lithium battery on bilateral paralysis of the vocal cords. This therapeutic modality may be more effective, non-invasive, uncomplicated, tolerable, and affordable.

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“…However, the identification of the nerve trunks is necessary and the anatomical distribution in the distal part of the esophagus is determinant for the results and to avoid post-operative morbidity (Miyano et al, 2015;Razumosky et al, 2015). Segmental resection of the esophagus (Gopal et al, 2015) is not a frequent operation but the surgical results depend on the location and extension of the damaged segment, and the possibility to save the nerve trunks and branches. Esophageal replacement (with colon) for the treatment of congenital or acquired atresia in children or adults, with or without fistula, and unavoidable sacrifice of vagus nerves is the most extended procedure with higher morbidity and mortality (Spitz, 2014;Ezemba, 2014;Fragoso et al, 2015;Ortiz et al, 2015).…”

Section: Discussionmentioning

confidence: 99%

THORAX-ABDOMINAL VAGUS NERVES IN FETUSES. Nervios vagos toraco-abdominales en fetos

Biasutto

Ceccón

Rosa

et al. 2016

Rev Arg de Anat Clin

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Los nervios vagos han sido exhaustivamente estudiados en los adultos pero no en los niños, y mayormente en el trayecto intracraneal, más que en la periferia. El objetivo de este estudio fue proveer información más específica sobre los nervios vagos toraco-abdominales, describirlos en fetos y asociarlos con la rotación gástrica, de modo que pueda ser aplicada a procedimientos clínicos, reduciendo la morbilidad. Se disecaron treinta fetos entre 12 y 23 semanas de gestación, mayormente varones (87%), desde la parte inferior del cuello hasta el cardias, identificando los troncos y ramas de los nervios vagos. Los nervios fueron descriptos en su ingreso en el tórax en relación con las arterias carótidas, en su posición en el tercio superior del esófago asociados con el origen de las ramas cardíacas y pulmonares, en el tercio inferior del esófago con muchas variaciones en su distribución, a nivel diafragmático en el hiato esofágico y, finalmente, en relación con la posición gástrica. La discusión involucró descripciones hechas por diferentes autores incluyendo algunos estudios recientes que proporcionan resultados electrofisio-lógicos y consideraciones de aspectos clínicos, principalmente representados por procedimientos quirúrgicos y su morbilidad, ambos asociados con la lesión de los nervios vagos. Vagus nerves have been extensively studied in adults but not in fetuses, and mostly in the intracranial pathway than the peripheral one. The objective of this study was to provide more specific information on the thorax-abdominal vagus nerves, to describe them in fetuses and to associate them with the gastric rotation, so it could be applied to clinical procedures, reducing morbidity. Thirty fetuses between 12 to 23 weeks of gestation, mainly male (87%), were dissected from the lower neck to the cardias, identifying vagus nerve trunks and braches. Vagus nerves were described at the entrance in the thorax in relation with the carotid arteries, in their position at the upper third of the esophagus associated with the origin of cardiac and pulmonary branches, in the lower third of the esophagus with many variations in their distribution, at the diaphragmatic level in the esophageal hiatus and, finally, in relation with the gastric position. The discussion involved descriptions made by different authors including some recent studies providing electrophysiological results and considerations on clinical aspects, mainly represented by surgical procedures and their morbidity associated, both to vagus nerve injury.

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Repair of tracheo-oesophageal fistula secondary to button battery ingestion: A combined cervical and median sternotomy approach

Cited by 11 publications

References 6 publications

Analysis of Complications After Button Battery Ingestion in Children

Analysis of Complications After Button Battery Ingestion in Children

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THORAX-ABDOMINAL VAGUS NERVES IN FETUSES. Nervios vagos toraco-abdominales en fetos

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