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Cylindrical and button battery ingestion in children: a single-center experience
Kh A Akilov1,2, D R Asadullaev1, R Z Yuldashev3
1Republican Research Center of Emergency Medicine, Tashkent, Uzbekistan.
Insights
Button battery (BB) ingestion in children causes more severe esophageal damage than cylindrical batteries (CBs). Timely endoscopic removal is crucial for reducing gastrointestinal mucosal injuries, especially for BBs.
Area of Science:
- Pediatric Gastroenterology
- Toxicology
- Medical Device Safety
Background:
- Button battery (BB) and cylindrical battery (CB) ingestions are common pediatric emergencies.
- Battery type, size, and location significantly influence clinical outcomes and management strategies.
Purpose of the Study:
- To compare examination and treatment outcomes in children with cylindrical and button battery ingestions.
- To analyze the impact of battery size and anatomical location on pediatric battery ingestions.
Main Methods:
- Retrospective analysis of 124 children (1 month to 18 years) treated for battery ingestion from 2014-2019.
- Data collected included patient demographics, battery type/size, presenting symptoms, and management modality.
- Outcomes assessed included hospital stay duration, endoscopic vs. surgical intervention, and gastrointestinal mucosal injury.
Main Results:
- Button batteries (BBs) were ingested by 81.5% of children, while cylindrical batteries (CBs) accounted for 18.5%.
- Ingestion of BBs larger than 20 mm resulted in significantly longer hospital stays.
- Esophageal BB impaction led to severe mucosal damage (96%), while gastric BBs caused superficial damage (19.5%). CBs more frequently caused gastric mucosal injuries (55%).
Conclusions:
- Early endoscopic retrieval is vital to minimize gastrointestinal mucosal damage, particularly in the stomach.
- Cylindrical batteries (CBs) are more likely to be retained in the stomach, leading to gastric injuries.
- Endoscopic extraction is the preferred treatment for pediatric button battery ingestions due to higher risks of severe esophageal damage.
Purpose:
The purpose of our study was to perform a comparative analysis of the examination and treatment outcomes of children with cylindrical and button batteries (BB) ingestion depending on their size and anatomical locations.
Methods:
This study was a retrospective analysis of 124 children aged from 1 month to 18 years who ingested batteries and were treated in a tertiary care center from January 1, 2014 to March 31, 2019. The data studied included age, sex, presenting symptoms at the time of evaluation, type and size of battery and modality of management.
Results:
Twenty-three (18.5%) patients ingested cylindrical batteries (CBs), and 101 (81.5%) ingested BBs. The duration of hospital stay was significantly longer (p = 0.004) in the group of children who ingested BBs larger than 20 mm. Endoscopic removal was performed in 75 (60.5%) children, 46 (37.1%) were followed up and three (2.4%) underwent open surgeries. Children with CBs ingestion, in 55% of cases, had gastric mucosal injuries. Children with BBs impacted in the esophagus in 96% cases had visible severe mucosal damage, whereas patients with gastric BB ingestion 19.5% had superficial gastric mucosal damage.
Conclusion:
Performing timely endoscopic retrieval in children who are admitted early to the hospital will reduce the risk of damage to the gastrointestinal mucosa, especially in the stomach. Unlike BBs, CBs, despite their large size, have advantageous shapes, uneventfully pass the esophagus and are more often retained in the stomach; thus, mucosal injuries are more often observed in the stomach. Consequently, endoscopic extraction is the treatment of choice for children with BB ingestion.
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