WOFAPS 2025 8th World Congress of Pediatric Surgery

Vildan Selin Çayhan ¹, Süleyman Arif Bostancı ², Ahmet Ertürk ², Elif Emel Erten ¹, Can İhsan Öztorun ², Emrah Şenel ², Müjdem Nur Azılı ²

¹ Ankara Bilkent City Hospital Department of Pediatric Surgery, Ankara
² Ankara Yıldırım Beyazıt Unıversıty Medical Faculty Department of Pediatric Surgery

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Aim: Button batteries can rapidly lead to tissue necrosis and esophageal perforation. This study evaluated patients who presented with esophageal button battery ingestion.

Methods: From 2020 to 2025, we conducted a retrospective review of 10 pediatric patients with esophageal button battery impaction. The following data were collected for each patient: age, sex, time to admission, presenting symptoms, radiological findings, battery retention time, endoscopic findings, complications, and clinical outcomes (Table).

Results: The mean age was 3 years, with five males and five females. Seven patients presented within six hours of ingestion and underwent urgent esophagoscopy. Mucosal injuries ranged from Grade 2A to 3A (Zargar classification), and no major complications were observed in patients who presented early. However, three patients presented more than 24 hours after ingestion and all of them developed severe complications. One patient died due to a late-onset aortoesophageal fistula. Another patient developed an esophageal perforation and subsequently experienced life-threatening hemorrhaging due to a fistula between the esophagus and an aberrant subclavian artery. A third patient was initially misdiagnosed with an upper respiratory infection and remained undiagnosed for ten days. Endoscopy revealed a tracheoesophageal fistula, and surgical repair was performed.

Conclusion: The occurrence of life-threatening complications, including aortoesophageal fistulas, esophageal perforations, and tracheoesophageal fistulas, in all late-presenting patients (30% of our cases) underscores the severity of battery ingestion in the esophagus.

Age (years) Sex Time for esophagoscopy after ingestion Presenting symptoms Localization of battery in esophagus Zargar classification Follow-up 1 Boy 3 hours Vomiting Upper 2B Uneventful 1 Girl 10 days Hoarseness, wheezing, and coughing Upper 3B Tracheoesophageal fistula 2 Girl 6 hours Vomiting Upper 2B Uneventful 5 Girl 5 days Coughing and vomiting Mid-esophagus 3A The patient died due to bleeding due to aortoesophageal fistula and exitus. 4 Boy 4 hours None Upper 2A Uneventful 2 Girl 6 hours Vomiting Mid-esophagus 2A Uneventful 2 Boy 6 hours Choking Upper 2B Uneventful 4 Boy 5 hours None Mid-esophagus 3A Uneventful 3 Boy 24 hours Hypersalivation Upper Esophageal perforation Esophageal stricture 6 Girl 5 hours Sudden shortness of breath and cyanosis Lower esophagus 3A Uneventful