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Evaluation of a Symptom-Based Algorithm for Managing Battery Ingestions in Children
James A Fraser1, Kayla B Briggs1, Wendy Jo Svetanoff1
1Department of Pediatric Surgery, Children's Mercy Hospitals and Clinics, Kansas City, Missouri, United States.
Summary
A symptom-focused approach to button battery ingestions is safe and effective. Observation over immediate intervention can avoid unnecessary admissions and procedures for many patients.
Area of Science:
- Pediatric Gastroenterology
- Emergency Medicine
- Radiology
Background:
- Button battery ingestions pose significant risks, particularly with modern battery designs.
- Current management often involves prompt removal, even in asymptomatic cases.
- A need exists to evaluate conservative, symptom-focused management strategies.
Purpose of the Study:
- To assess the safety and efficacy of a symptom-focused algorithm for button battery ingestions.
- To determine if conservative management reduces the need for intervention and admission.
Main Methods:
- Retrospective review of radiographs showing button battery ingestions (2017-2020).
- Analysis of patient charts for adherence to a symptom-focused algorithm.
- Evaluation of outcomes, including complications and need for intervention.
Main Results:
- Button batteries were found in the esophagus, stomach, small bowel, and colon.
- Esophageal batteries required immediate endoscopic retrieval.
- Gastric and lower gastrointestinal batteries, when asymptomatic, were often managed conservatively with good outcomes.
- Some patients managed non-protocol experienced interventions or admissions despite being asymptomatic.
Conclusions:
- A symptom-focused protocol for button battery ingestions distal to the esophagus is safe.
- Conservative management frequently avoids the need for admission, serial imaging, or endoscopic intervention.
- This approach can streamline care and reduce healthcare resource utilization.
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