Oesophageal impaction of button batteries in children: a tertiary centre experience

Among foreign body ingestions in children, button battery ingestion is becoming increasingly common. When the battery is impacted in the oesophagus, the risk of complications is significant. The aim of this study was to share our experience in managing children with oesophageal button battery impaction and assess the occurrence of short-term and long-term complications.

This was a retrospective study conducted at a tertiary French paediatric centre. Children with oesophageal button battery impaction managed between 1 January 2017 and 31 December 2022 were included. Clinical data, endoscopic findings and treatments were recorded at battery removal and during follow-up at 1 week and at 1, 3 and 12 months. Complications were noted at each follow-up. Patients were compared based on the presence or absence of complications to identify associated risk factors.

Among 79 children included in the study, 31 experienced one or more complications by 12 months postingestion: oesophageal stenosis (n=14), mediastinitis (n=18), tracheoesophageal fistula (n=3), oesophageal perforation (n=5) and vocal cord paralysis (n=3). Most complications were diagnosed within the first week, except for oesophageal stenosis, which had an average delay of 38.2 days. Risk factors for complications included younger age, longer time to battery removal and oesophageal mucosal necrosis observed during follow-up endoscopy 1 week postremoval.

The rate of complications following oesophageal button battery impaction remains high. However, protocolised management involving rapid battery extraction, early endoscopic review and intraoperative nasogastric tube placement may reduce the risk of severe complications and oesophageal stenosis.