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The anesthetic management of button battery ingestion in children

Richard J Ing1, Monica Hoagland2, Lena Mayes2

  • 1Department of Anesthesiology, Children's Hospital Colorado and University of Colorado, Anschutz Medical Campus, 13123 E. 16th Ave, Aurora, CO, USA. richard.ing@childrenscolorado.org.

Canadian Journal of Anaesthesia = Journal Canadien D'Anesthesie
|November 24, 2017
PubMed

Insights

Button battery ingestion in children is a serious concern, often leading to severe injury. This review details the risks, management, and anesthetic considerations for pediatric button battery ingestions.

Area of Science:

  • Pediatric Gastroenterology
  • Emergency Medicine
  • Anesthesiology

Background:

  • Button batteries are common household items, with newer larger and higher voltage batteries increasing ingestion risks.
  • Ingestion can cause severe caustic injury, morbidity, and mortality, particularly in children under six.
  • Esophageal impaction, especially at the aortic arch, poses the highest risk.

Purpose of the Study:

  • To review the epidemiology of button battery ingestion in children.
  • To outline the pathophysiology and complications associated with button battery ingestion.
  • To detail the management and anesthetic implications for pediatric patients.

Main Methods:

  • A comprehensive literature search was performed using PubMed and internet searches.
  • Keywords included "button battery ingestion," "children," "removal," "surgery," and "anesthesia."
  • 62 relevant articles from 1983-2017 were included, supplemented by additional online resources.

Main Results:

  • Button battery ingestion is a frequent pediatric emergency.
  • Larger, higher-voltage batteries (since 2006) increase the risk of esophageal impaction and severe injury.
  • Children under six ingesting batteries >20mm, impacted at the aortic arch with specific orientation, are at highest risk.

Conclusions:

  • Anesthesiologists must be aware of the risks and management strategies for pediatric button battery ingestions.
  • Understanding the epidemiology, pathophysiology, and complications is crucial for effective patient care.
  • Proper anesthetic management is vital for children undergoing procedures for button battery removal.
Abstract

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