Management of Vascular Complications from Button Battery Ingestions

Area of Science:

• Gastroenterology
• Pediatric Gastroenterology
• Medical Device Safety

Background:

• Button battery ingestions pose serious risks, particularly in young children, with a high mortality rate from associated gastrointestinal bleeding.
• Vascular injury from button batteries is a rare but often fatal complication, lacking evidence-based management guidelines.

Purpose of the Study:

• To propose a novel management algorithm for gastrointestinal bleeding caused by button battery ingestion.
• To incorporate an endoscopic and imaging scoring system into the algorithm for guiding patient care.
• To specify management strategies for button battery-related vascular complications.

Main Methods:

• Development of a modified Zargar endoscopic scoring system including categories for suspected aneurysm and tracheoesophageal fistula.
• Review of surgical and endovascular interventions for managing vascular injuries.
• Proposal of a multidisciplinary protocol for rapid management of button battery-related vascular injury.

Main Results:

• The proposed algorithm integrates endoscopic and imaging scores to guide initial, post-procedure, and discharge care.
• The algorithm addresses the specific management of rare but life-threatening vascular bleeding from button battery ingestions.
• Current management relies on institutional expertise and multidisciplinary protocols due to a lack of evidence-based guidelines.

Conclusions:

• A new algorithm is proposed for managing button battery-related gastrointestinal bleeding, incorporating scoring systems for endoscopic and imaging findings.
• Hospitals should establish multidisciplinary protocols to manage these severe vascular complications promptly.
• Prevention through public awareness and improved industry safety standards is crucial to reduce button battery injuries.