Electric Insulating Irrigations Mitigates Esophageal Injury Caused by Button Battery Ingestion

ObjectiveAccidental ingestion of button batteries (BB), usually occurred in children and infants, will rapidly erode the esophagus and result in severe complications, even death. It has been recommended that treatment of this emergent accident as soon as possible with drinking of pH-neutralizing vis...

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Main Authors: Wenyuan Jia, Guanghui Xu, Jiangang Xie, Luming Zhen, Mengsha Chen, Chuangye He, Xulong Yuan, Chaoping Yu, Ying Fang, Jun Tie, Haidong Wei
Format: Article
Language:English
Published: Frontiers Media S.A. 2022-05-01
Series:Frontiers in Pediatrics
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fped.2022.804669/full
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author Wenyuan Jia
Guanghui Xu
Jiangang Xie
Luming Zhen
Mengsha Chen
Chuangye He
Xulong Yuan
Chaoping Yu
Ying Fang
Jun Tie
Haidong Wei
author_facet Wenyuan Jia
Guanghui Xu
Jiangang Xie
Luming Zhen
Mengsha Chen
Chuangye He
Xulong Yuan
Chaoping Yu
Ying Fang
Jun Tie
Haidong Wei
author_sort Wenyuan Jia
collection DOAJ
description ObjectiveAccidental ingestion of button batteries (BB), usually occurred in children and infants, will rapidly erode the esophagus and result in severe complications, even death. It has been recommended that treatment of this emergent accident as soon as possible with drinking of pH-neutralizing viscous solutions such as honey and sucralfate before surgical removal can mitigate the esophageal injury. Recently, we reported that the electric insulating solutions such as edible oils could mitigate tissue damage in BB-exposed esophageal segments. In this study, we compared the protective effect of kitchen oil with honey or sucralfate, the recommended pH-neutralizing beverages, and with their mixture on esophageal injury caused by BB ingestion in pig esophageal segments and in living piglets.MethodsEffect of olive oil irrigations was compared to that of honey or sucralfate irrigations in the BB-damaged esophageal segments freshly collected from the local abattoir and in live Bama miniature piglets with the proximal esophagus exposed to BB for 60 min. Also, the effect of olive oil and honey mixture (MOH) irrigations was assessed in live animals. The BB voltage was recorded before insertion and after its removal. Gross and histological analysis of the esophageal injury was performed after BB exposure in segmented fresh esophagus and 7 days after BB exposure in live animals, respectively.ResultsOlive oil irrigations demonstrated better protective effect against BB-induced esophageal damage, compared to honey or sucralfate for BB-induced esophageal damage in vitro. But in vivo study showed that olive oil alone exacerbated esophageal injury because all esophagi irrigated with olive oil perforated. Surprisingly, irrigations with the MOH showed considerable protective effect for BB-induced esophageal damage in live animals, significantly better than irrigations with honey alone. The MOH decreased BB discharge, reduced area of surface injury, attenuated injured depth of esophageal wall thickness, and downed the mucosal injury index in comparison to using honey alone.ConclusionIrrigations with olive oil alone couldn’t prevent the BB discharge and is harmful for BB ingestion before surgical removal. However, mixed with honey, olive oil very effectively prevents the BB discharging and produces better esophageal protection than honey.
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spelling doaj.art-b0e30d8204eb40cf8e2fccba8035e64f2022-12-22T02:21:09ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602022-05-011010.3389/fped.2022.804669804669Electric Insulating Irrigations Mitigates Esophageal Injury Caused by Button Battery IngestionWenyuan Jia0Guanghui Xu1Jiangang Xie2Luming Zhen3Mengsha Chen4Chuangye He5Xulong Yuan6Chaoping Yu7Ying Fang8Jun Tie9Haidong Wei10Digestive Diseases of Xijing Hospital, Fourth Military Medical University, Xi’an, ChinaDigestive Diseases of Xijing Hospital, Fourth Military Medical University, Xi’an, ChinaDepartment of Emergency, Xijing Hospital, Fourth Military Medical University, Xi’an, ChinaDepartment of Anesthesiology, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an Jiaotong University, Xi’an, ChinaDepartment of Anesthesiology, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an Jiaotong University, Xi’an, ChinaDigestive Diseases of Xijing Hospital, Fourth Military Medical University, Xi’an, ChinaDigestive Diseases of Xijing Hospital, Fourth Military Medical University, Xi’an, ChinaDepartment of Emergency, Xijing Hospital, Fourth Military Medical University, Xi’an, ChinaDepartment of Gastroenterology, Xi’an Children’s Hospital, Xi’an, ChinaDigestive Diseases of Xijing Hospital, Fourth Military Medical University, Xi’an, ChinaDepartment of Anesthesiology, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an Jiaotong University, Xi’an, ChinaObjectiveAccidental ingestion of button batteries (BB), usually occurred in children and infants, will rapidly erode the esophagus and result in severe complications, even death. It has been recommended that treatment of this emergent accident as soon as possible with drinking of pH-neutralizing viscous solutions such as honey and sucralfate before surgical removal can mitigate the esophageal injury. Recently, we reported that the electric insulating solutions such as edible oils could mitigate tissue damage in BB-exposed esophageal segments. In this study, we compared the protective effect of kitchen oil with honey or sucralfate, the recommended pH-neutralizing beverages, and with their mixture on esophageal injury caused by BB ingestion in pig esophageal segments and in living piglets.MethodsEffect of olive oil irrigations was compared to that of honey or sucralfate irrigations in the BB-damaged esophageal segments freshly collected from the local abattoir and in live Bama miniature piglets with the proximal esophagus exposed to BB for 60 min. Also, the effect of olive oil and honey mixture (MOH) irrigations was assessed in live animals. The BB voltage was recorded before insertion and after its removal. Gross and histological analysis of the esophageal injury was performed after BB exposure in segmented fresh esophagus and 7 days after BB exposure in live animals, respectively.ResultsOlive oil irrigations demonstrated better protective effect against BB-induced esophageal damage, compared to honey or sucralfate for BB-induced esophageal damage in vitro. But in vivo study showed that olive oil alone exacerbated esophageal injury because all esophagi irrigated with olive oil perforated. Surprisingly, irrigations with the MOH showed considerable protective effect for BB-induced esophageal damage in live animals, significantly better than irrigations with honey alone. The MOH decreased BB discharge, reduced area of surface injury, attenuated injured depth of esophageal wall thickness, and downed the mucosal injury index in comparison to using honey alone.ConclusionIrrigations with olive oil alone couldn’t prevent the BB discharge and is harmful for BB ingestion before surgical removal. However, mixed with honey, olive oil very effectively prevents the BB discharging and produces better esophageal protection than honey.https://www.frontiersin.org/articles/10.3389/fped.2022.804669/fullbutton batteryforeign bodyesophageal injuryedible oilinsulation
spellingShingle Wenyuan Jia
Guanghui Xu
Jiangang Xie
Luming Zhen
Mengsha Chen
Chuangye He
Xulong Yuan
Chaoping Yu
Ying Fang
Jun Tie
Haidong Wei
Electric Insulating Irrigations Mitigates Esophageal Injury Caused by Button Battery Ingestion
Frontiers in Pediatrics
button battery
foreign body
esophageal injury
edible oil
insulation
title Electric Insulating Irrigations Mitigates Esophageal Injury Caused by Button Battery Ingestion
title_full Electric Insulating Irrigations Mitigates Esophageal Injury Caused by Button Battery Ingestion
title_fullStr Electric Insulating Irrigations Mitigates Esophageal Injury Caused by Button Battery Ingestion
title_full_unstemmed Electric Insulating Irrigations Mitigates Esophageal Injury Caused by Button Battery Ingestion
title_short Electric Insulating Irrigations Mitigates Esophageal Injury Caused by Button Battery Ingestion
title_sort electric insulating irrigations mitigates esophageal injury caused by button battery ingestion
topic button battery
foreign body
esophageal injury
edible oil
insulation
url https://www.frontiersin.org/articles/10.3389/fped.2022.804669/full
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