Button Battery Ingestion in Children: Experience in Kurdistan Center for Gastroenterology and Hepatology

Adnan Mh Hamawandi,Aram Baram Taha A Karboli

doi:10.4172/2161-0665.1000258

Abstract

Background: The vast majority of button battery (BB) ingestions occur when curious children explore their environment. Button batteries do not usually cause problems unless they become lodged in the gastrointestinal tract. Objective: To report our experience of button battery ingestion in children focusing on clinical characteristics, management, and outcomes. Patients and methods: Between January 2006 to June 2015 all cases of BB ingestion presented to the Kurdistan center for Gastroenterology and Hepatology (KCGH), Sulaimani, Iraq, were reviewed retrospectively. The diagnosis based on history, clinical examination and results of imaging studies. The clinical data reviewed included gender, age, clinical manifestation, hospital course, imaging findings and endoscopic findings. Results: Twenty children with button battery ingestion referred to KCGH; 12 male and 8 female patients with age range of 10 months to 70 months and the mean age of 28 months. Seven patients passed the batteries spontaneously in the stool without harm within 2-5 days. In13 patient batteries were retrieved endoscopically from the esophagus in 7 patients and from the stomach in 6 patients. The endoscopic findings in the 7 patients in whom the button batteries were in the esophagus were; severe injury in 5 patients, mild injury in 2 patients; there was perforation of the esophagus in 4 patients associated with Tracheoesophageal Fistula in three patients. Conclusion: Severe injury can occur rapidly following BB ingestion particularly when they are lodged in the esophagus. A high index of suspicion for a BB is necessary to avoid life-threatening sequel. Emergency endoscopic retrieval is required in these situations.

Highlights

Button batteries (BB) are small coin shaped batteries used to power small portable electronic devices such as wrist watches, pocket calculators, artificial cardiac pacemakers, implantable cardiac defibrillators, hearing aids and children toys
Twenty children with button battery ingestion referred to Kurdistan center for Gastroenterology and Hepatology (KCGH); 12 male and 8 female patients with age range of 10 months to 70 months and the mean age of 28 months
The endoscopic findings in the 7 patients in whom the button batteries were in the esophagus were; severe injury in 5 patients, mild injury in 2 patients; there was perforation of the esophagus in 4 patients associated with Tracheoesophageal Fistula in three patients

Summary

Introduction

Button batteries (BB) are small coin shaped batteries used to power small portable electronic devices such as wrist watches, pocket calculators, artificial cardiac pacemakers, implantable cardiac defibrillators, hearing aids and children toys. The vast majority of BB ingestions occur when curious children explore their environment [2]. Button batteries do not usually cause problems unless they become lodged in the GI tract. The most common place for BB to become lodged in, and resulting in serous clinical sequels, is the esophagus [4]. If a battery becomes impacted in the esophagus, it may penetrate the esophageal wall and cause a tracheo-esophageal fistula and even fistulization into major vessels with massive haemorrhage [8] Injury can continue after endoscopic battery removal for days to weeks due to residual alkali or weakened tissues [9]. The vast majority of button battery (BB) ingestions occur when curious children explore their environment. Button batteries do not usually cause problems unless they become lodged in the gastrointestinal tract

Methods

Results

Conclusion