Button battery ingestion in older people: Prospective study and management algorithm

Abstract

People over 60 years old represent 4 to 16% of all incidents with button batteries. Significant necrotic lesions can appear as early as 2 hours following ingestion. This can induce esophagus perforation and lead to death. To determine cause of ingestion, clinical manifestations and outcome of button battery ingestion in older people. PilBouTox® was a 2 years prospective observational multicenter cohort study conducted by all French poison control centers for button battery ingestion in people aged 65 and over. After ingestion or insertion, patients were monitored for 21 days. We recorded cause of ingestion, button battery description, clinical manifestations, use of X-ray, endoscopy or surgery, duration of hospitalization and outcome. The patient mean age was 85 ± 7 years old with 64% being women. The incidence was 0.27 ingestion/100,000 aged people/year. In 82% of cases, only one battery was ingested. Seventy-six percent of the button batteries ingested came from the hearing aids. Ninety-four percent of patients were asymptomatic but 2 patients died: one unrelated and one potentially related. Three gastric endoscopies were performed, and one found distal esophagus lesion Forrest III. With simple precautionary advice, we can prevent 94% of button battery ingestions in older people. We proposed management algorithm for button battery ingestions in older people. Button battery ingestions appeared as an uncommon event. Button batteries ingestions can cause severe esophagus or gastric ulceration. Hearing aid batteries are mostly involved in older people without medical importance. Only one case of esophagus impaction needing endoscopic removal was recorded.