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Button battery ingestion in children: Experience from a tertiary center on 56 patients
Syed Shafiq1, Harshad Devarbhavi2, Gurappa Balaji3
1Department of Medical Gastroenterology, St. John's Medical College Hospital, Sarjapur Road, Bengaluru, 560 034, India. syed.dr.s@gmail.com.
Insights
Button battery ingestion in children often resolves spontaneously or with endoscopic removal. Larger batteries (≥10 mm) pose a risk for esophageal impaction and serious complications, though mortality was not observed in this study.
Area of Science:
- Pediatric Gastroenterology
- Emergency Medicine
- Otolaryngology
Background:
- Button battery (BB) ingestion is a growing concern in children due to the prevalence of portable electronic devices.
- BB ingestion is a critical medical emergency associated with significant morbidity and mortality.
- This study details clinical experience managing pediatric BB ingestions.
Purpose of the Study:
- To analyze the clinical and endoscopic management of children with button battery ingestion.
- To identify risk factors and complications associated with button battery ingestions in pediatric patients.
Main Methods:
- Retrospective review of 56 children (≤18 years) presenting with BB ingestion from December 2016 to November 2019.
- Data collected included patient demographics, time to retrieval, endoscopic findings, and complications.
- Analysis of spontaneous passage, endoscopic retrieval, and impaction sites.
Main Results:
- Of 56 ingestions, 10 passed spontaneously, and 27 required endoscopic removal.
- Nineteen BBs impacted, primarily in the upper esophagus (9/19), all with larger batteries (≥10 mm).
- Complications occurred in 3 children (5.35%), including esophageal strictures and perforation; no mortality was reported.
Conclusions:
- Most button battery ingestions resolve without severe outcomes.
- Larger BBs (≥10 mm) are associated with a higher risk of esophageal impaction and subsequent serious complications.
- Prompt endoscopic evaluation and management are crucial for pediatric button battery ingestions.
Background/Aim:
The ubiquitous use of portable electronic devices has resulted in an increased incidence of button battery (BB) ingestion in children. BB ingestion represents a distinct category of ingested foreign body due to the associated high morbidity and mortality. The aim of this study was to report our experience in the management of BB ingestion in children.
Methods:
We reviewed the clinical and endoscopic characteristics of 56 children (≤ 18 years) who presented to our hospital emergency department (ED) with BB ingestion between December 2016 and November 2019. Data with respect to patient demographics, time of presentation to ED to endoscopic retrieval of BB, the endoscopic findings, and complications, if any, were collected.
Results:
We encountered a total of 56 children with BB ingestions. While 10 BBs passed off spontaneously without any complication, 27 BBs were extracted endoscopically from the stomach. A total of 19 BB impactions occurred: 9 at the cricopharynx/upper esophageal sphincter (UES), 5 in the mid esophagus, 4 in the lower esophagus, and one at the pyloric ring. All impactions occurred with larger BBs (diameter ≥ 10 mm). Complications occurred in 3 children (5.35%) following retrieval; 2 developed upper esophageal strictures on follow-up, which were treated with serial dilations and one experienced esophageal perforation and peritonitis requiring laparotomy. There was no mortality in our study.
Conclusions:
A vast majority of ingested BBs pass off spontaneously or require minimal endoscopic intervention. Serious complications arise in a small minority especially in BBs > 10 mm in size with a potential for esophageal impaction.
