Current management of button battery injuries.

Area of Science:

• Pediatric Gastroenterology
• Toxicology
• Medical Device Safety

Background:

• Button batteries (BBs) in household items pose a significant risk of severe morbidity and mortality in children when ingested.
• Esophageal impaction of BBs causes rapid caustic injury due to a high local pH (10-13), leading to liquefactive necrosis.
• Symptoms can be vague, mimicking viral illnesses, and ingestion history may be absent, delaying diagnosis.

Purpose of the Study:

• To review the pathophysiology, diagnosis, and management of pediatric button battery ingestions.
• To highlight current and novel treatment strategies, including mitigation and neutralization.
• To emphasize the importance of prevention through regulation, industry changes, and data collection.

Main Methods:

• Review of existing literature and clinical guidelines on button battery ingestions.
• Discussion of diagnostic modalities, including plain film X-ray.
• Description of endoscopic removal techniques and adjunctive therapies (honey, sucralfate, acetic acid irrigation).

Main Results:

• Button battery exposure can cause severe caustic injury within 2 hours.
• Timely endoscopic removal is the primary treatment, with potential for delayed, life-threatening complications like fistulization.
• Mitigation strategies like honey or sucralfate ingestion and acetic acid irrigation are part of current guidelines.

Conclusions:

• Prompt recognition and multidisciplinary management are essential for optimizing outcomes in pediatric button battery ingestions.
• Prevention strategies, including child-resistant packaging and public awareness, are critical.
• Development of safer button battery technology is urgently needed to reduce severe injuries.