What is a potential intervention that can be done intra-operatively to halt the progression of injury in the setting of pediatric button battery ingestion retained in the esophagus?
Immediate esophageal irrigation in the operating room with sterile 0.25% acetic acid after button battery removal.
This intervention appeared to be safe, was not associated with any significant change in tissue temperature, and appeared to neutralize the highly alkaline tissue microenvironment (pH 10–13). In this case series of 6 patients, it halted the progression of liquefactive necrosis, which usually occurs even when the button battery is removed.
Jatana KR, Barron CL, Jacobs IN. Initial clinical application of tissue pH neutralization after esophageal button battery removal in children. Laryngoscope. 2019;129(8):1772-1776. doi:10.1002/lary.27904
Contributed by: Han Gao, MD