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Button battery ingestion requiring upper gastrointestinal endoscopy: A retrospective study at a tertiary care
María I Viale1, Gabriela Messere1, María P Gavaise1
1Pediatric Gastroenterology Department; Hospital Nacional Profesor Alejandro Posadas, El Palomar, Argentina.
Insights
Button battery ingestion in children is an emergency. Hypersalivation and esophageal impaction in pediatric patients indicate severe injuries requiring prompt endoscopic evaluation.
Area of Science:
- Pediatric Gastroenterology
- Emergency Medicine
- Otolaryngology
Background:
- Button battery ingestion is a critical pediatric emergency.
- Esophageal injury risk necessitates timely intervention.
- Upper gastrointestinal endoscopy is crucial for diagnosis and management.
Purpose of the Study:
- To characterize clinical and endoscopic findings in pediatric button battery ingestions.
- To identify factors associated with severe esophageal lesions.
- To analyze the clinical course of button battery ingestion requiring endoscopy.
Main Methods:
- Retrospective, observational study of 106 pediatric patients (<15 years) with button battery ingestion.
- Radiological diagnosis confirmed prior to upper gastrointestinal endoscopy.
- Data collected on demographics, symptoms, lesion location, and clinical outcomes.
Main Results:
- Hypersalivation (33.9%) was the most common symptom and significantly associated with severe lesions (OR 8.115).
- Upper esophageal lesions (2.461) also correlated with increased severity.
- Esophageal impaction was frequent and linked to a high rate of severe injuries.
Conclusions:
- Button battery impaction in the esophagus is common and associated with severe injuries.
- Hypersalivation is a key indicator of injury severity in pediatric button battery ingestions.
- Prompt endoscopic assessment is vital for managing button battery ingestions in children.
Abstract:
Introduction. Ingestion of a button battery constitutes an endoscopic emergency due to the risk of serious injury. Objective. To describe the clinical, endoscopic, and clinical course characteristics of patients who swallowed a button battery and required upper gastrointestinal endoscopy in the pediatric emergency department of a tertiary care center between 2014 and 2024. Population and methods. Observational, descriptive, and retrospective study. The study included patients younger than 15 years of age with a radiological diagnosis of button-cell battery ingestion who underwent upper gastrointestinal endoscopy. Results. A total of 106 patients (63 males) were included. The median age was 24 months (IQR 15-48); 35.8% of the patients were initially evaluated at another institution. In 51% of cases, the time since ingestion was unknown. At the time of consultation, 39/106 patients (36.5%) were asymptomatic. Among those with symptoms (67/106), the most common symptom was hypersalivation, present in 36/106 patients (33.9% of the total). Hypersalivation was significantly associated with severe lesions (OR 8.115; 95%CI 2.913-24.3; p <0.01). Lesions located in the upper esophagus also showed a significant association (OR 2.461; 95%CI 1.077-5.775; p = 0.029). Conclusion. Esophageal impaction was common and was associated with a high percentage of severe injuries. Hypersalivation was significantly associated with greater severity.
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