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Battery ingestions in children: Variations in care and development of a clinical algorithm

Eric H Rosenfeld1, Richard Sola2, Yangyang Yu1

  • 1Texas Children's Hospital / Baylor College of Medicine, Division of Pediatric Surgery, 6701 Fannin Suite 1210, Houston, TX 77030, United States.

Journal of Pediatric Surgery
|March 1, 2018
PubMed

Insights

Ingested batteries in children rarely need intervention if they pass the gastroesophageal junction. A new evidence-based algorithm guides management for battery ingestions to improve outcomes.

Area of Science:

  • Pediatric Gastroenterology
  • Emergency Medicine
  • Clinical Management

Background:

  • Battery ingestions are a common pediatric emergency.
  • Varied management approaches exist, necessitating standardized protocols.

Purpose of the Study:

  • To review current management and outcomes of ingested batteries in children.
  • To develop a clinical management algorithm for battery ingestions.

Main Methods:

  • Retrospective review of 180 children (<18 years) who ingested batteries.
  • Analysis of demographics, imaging, management, and outcomes.
  • Statistical analysis including descriptive statistics, Chi-square, and Wilcoxon Rank-sum tests.

Main Results:

  • Most common symptoms were abdominal pain (17%) and nausea/vomiting (14%).
  • Esophageal batteries (n=33) all required intervention, with rigid esophagoscopy showing a 96% retrieval rate.
  • Batteries distal to the gastroesophageal junction rarely required intervention (11% of cases).

Conclusions:

  • Isolated batteries passing the gastroesophageal junction can be managed conservatively.
  • An evidence-based algorithm was developed to standardize management and improve outcomes for pediatric battery ingestions.
Abstract

Keywords:
Foreign body ingestionbattery ingestionstandardized protocols

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