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Pediatric cylindrical battery ingestion
Maria Boccia1, Manuela Pugliese1, Marika Cantelli1
1Department of Translational Medical Sciences, Section of Pediatrics, Federico II University Hospital, Napoli, Italy.
Insights
Most pediatric cylindrical battery (CB) ingestions can be managed conservatively. However, timely removal is recommended for specific battery types, signs of distress, or prolonged retention to ensure positive clinical outcomes.
Area of Science:
- Pediatric Gastroenterology
- Toxicology
- Emergency Medicine
Background:
- Accidental battery ingestion is common in children.
- Data on pediatric cylindrical battery (CB) ingestions are limited.
- This study evaluates the characteristics and outcomes of CB ingestions in children.
Purpose of the Study:
- To analyze features of pediatric cylindrical battery ingestions.
- To describe clinical presentations and outcomes.
- To guide management strategies for CB ingestions.
Main Methods:
- Retrospective analysis of pediatric patients admitted for CB ingestion.
- Data collected: demographics, ingestion details, symptoms, battery type, imaging results, and endoscopic removal outcomes.
- Clinical course until hospital discharge was documented.
Main Results:
- 45 children (mean age 42 months) ingested AA or AAA batteries.
- CBs were most commonly found beyond the stomach (53.3%).
- No mucosal lesions or complications were reported after endoscopic removal in 12 patients.
Conclusions:
- Conservative management is suitable for most pediatric CB ingestions.
- Timely removal is advised for specific battery types (A23/A27), damaged batteries, multiple ingestions, prolonged gastric retention, or symptomatic children.
- This approach aims to prevent complications and ensure favorable outcomes.
Background And Study Aims:
Accidental ingestion of batteries is well documented in pediatric medical literature, but very few data exist in pediatric medical literature about ingestions of cylindrical batteries (CBs). The aim of our study was to evaluate the features, clinical presentation and clinical outcome of children who have ingested CBs.
Patients And Methods:
All children admitted for CB ingestion were retrospectively recruited. Clinical data until hospital discharge were accurately recorded, including child age and sex, ingestion modality, signs and symptoms following ingestion, type of CB, results of neck-chest-abdominal x-ray performed to assess the retention site of CB, outcome of endoscopic removal, and whether performed.
Results:
Forty-five children (males/females: 26/19; age range: 7-168 months; mean age ± standard deviation: 42 ± 33.9 months) were enrolled. Of them, 15 of 45 (33.3%) had ingested AA batteries whereas 30 of 45 (66.6%) had ingested AAA batteries. CBs were retained in the esophagus in two of 45 children (4.4%), in the stomach in 19 of 45 children (42.2%), and in the duodenum or beyond in the remaining 24 of 45 children (53.3%). None of the patients who underwent endoscopic removal (12/45) had any esophageal or gastric mucosal lesions. No cases of intestinal perforation or surgical complications were reported.
Conclusions:
According to our study data, conservative management may be advised for the majority of cases of CB ingestion. However, we acknowledge that CB should be timely removed whenever they are A23 or A27 type, damaged prior to ingestion, in cases of multiple ingestion, whenever retained in the stomach for a prolonged period, or whenever a child complains about any clinical signs or symptoms or had undergone prior abdominal surgery.
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