Zusammenfassung
Fremdkörperingestionen bei Kindern nehmen stetig zu – dabei werden u. a. Knopfbatterien
sehr häufig verschluckt. Das weitverbreitete Modell CR2032 führt bereits nach kurzer
Zeit zu schweren
Laugenverätzungen mit möglicher Perforation in benachbarte Organe. Dieser Fallserienbericht
stellt 4 Kinder vor, die nach Ingestion von Knopfbatterien eine tracheoösophageale
Fistel
entwickelten und in unserer Kinderklinik interdisziplinär versorgt wurden.
Abstract
Button battery ingestions in children increased in recent years and may lead to life-threatening
complications, especially if the battery is impacted in the esophagus. The pH close
to the
negative pole of the battery can rise in a very alkalotic range (pH > 10) leading
to severe tissue damage. Therefore, in this case series report, the clinical courses
of four children
with button battery ingestion leading to tracheoesophageal fistulas are presented.
The diagnosis and removal of the button battery was delayed in all cases. The surgical
reconstruction of
the trachea was performed in intravenous anesthesia and with extended monitoring.
The intraoperative oxygenation was maintained using a combination of extracorporeal
membrane oxygenation
(ECMO) and mechanical ventilation via an endobronchial tube. To prevent these
life-threatening complications, the awareness of the parents and child care providers
should be raised, and the
manufacturers should redesign their products to secure the battery compartment.
In children with suspected battery ingestions, the immediate localization and removal
of the battery
(< 2 h) is of highest importance. Local administration of honey or sucralfate
can be considered in ingestions < 12 h but should not delay an endoscopic removal.
Schlüsselwörter
Ingestion - Knopfbatterie - tracheoösophageale Fistel - Anästhesie - Kinder
Key words
ingestion - button battery - tracheoesophageal fistula - anesthesia - children
