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Published on: September 11, 2018
Analysis of Complications After Button Battery Ingestion in Children
Ágnes Varga, Tamás Kovács, Amulya K Saxena1
1Department of Pediatric Surgery, Chelsea Children's Hospital, Chelsea and Westminster NHS Foundation Trust, Imperial College London, London, United Kingdom.
Insights
Button battery ingestion in children, especially those under 6, poses significant risks. Larger batteries (≥20 mm) increase the likelihood of severe complications, primarily in the esophagus, with a notable fatality rate.
Area of Science:
- Pediatric Gastroenterology
- Toxicology
- Public Health
Background:
- Button battery ingestion (BBI) is a critical pediatric emergency.
- Potential for severe esophageal and systemic complications necessitates thorough understanding.
Purpose of the Study:
- To conduct a literature review on complications following pediatric button battery ingestion.
- To identify risk factors and patterns of injury associated with BBI.
Main Methods:
- Systematic literature search of PubMed (1995-2015) using keywords: "button battery," "ingestion," "children."
- Analysis of 31 publications, including patient demographics, battery characteristics, complications, affected organs, and outcomes.
Main Results:
- 136,191 pediatric cases analyzed; 75% were under 6 years old.
- Batteries ≥20 mm diameter were linked to higher complication rates (n=226).
- Esophageal complications were most common (38.94%), with 61 reported fatalities.
Conclusions:
- Children under 6 are most vulnerable to BBI complications.
- Lithium batteries ≥20 mm are associated with increased risk; vascular involvement is particularly fatal.
- Estimated complication rate: 0.165%; estimated lethality: 0.04%.
Aim:
Button battery ingestion (BBI) in children may cause severe complications. This analysis is a literature review of complications after pediatric BBI.
Methods:
Literature was searched on PubMed (1995-2015) using the terms "button battery," "ingestion," and "children." End points were age, type and diameter of battery, complications, affected organ, and fatality.
Results:
A total of 31 publications were analyzed. Patients from 4 months to 19 years old were included (n = 136,191, with n = 102,143 or 75% aged <6 y). In 6262, the diameter of the battery was documented. Batteries of 20 mm or greater in size were more prone to complications (n = 226). With regard to the anatomy, BBI caused complications mainly in the esophagus (n = 88, 38.94%). Sixty-one fatal outcomes were reported.
Conclusions:
Children younger than 6 years are the most prone to BBI, with lithium batteries of 20 mm or greater in size associated with complications. Complications have been estimated at 0.165%, with lethality of 0.04%. The esophagus is the most affected organ, but vascular involvement is often fatal.
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