Button Battery Ingestion Research Articles

Sa1547 Use of Endoscopic Ultrasound in Children As a Tool to Stratify High Risk Patients, After Button Battery Ingestions

Injuries to children caused by batteries have been documented in the medical literature and by poison control centers for decades . Of particular concern is the ingestion of button batteries, especially those ≥20 mm in diameter (coin size), which can lodge in the esophagus, leading to serious complications or death. Most of the children are treated and released or examined and released without treatment; approximately 10% required hospitalization. However, serios injuries and death have been reported, usually associated with esophageal perforation, tracheo-esophageal fistula and exsanguination from aorto-esophageal fistula. Some complications may happen several days after ingestion and or removal of battery. In order to stratify high risk patients we evaluated the use of endoscopic ultrasound as a tool to identify these patients. We evaluated 13 patients with button battery ingestions between 2007-2011, ages (1-5 years old), at time of initial endoscopy and removal of foreign body an endoscopic ultrasound was preformed to evaluate; degree of supeficial burn, and distance from trachea and aorta. We then divided patients into 2 groups (low risk and high risk). Based on initial assesment paitents were closely monitored or discharged home. 4 patients (30%) were considered high risk, these were admmited for close follow up, 2 of these had chest MRI, due to concern for possible aorto-esophageal fistula. No mayor complications defined as perforation, tracheo o aorto esophageal fistula were seen. Endoscopic ultrasound can be a useful tool during the initial evaluation of children with potentialy serious foreign body ingestions, can possibly stratisfy high risk patients for close follow up, and decrease cost of performing unnecessary tests or admmisions on low risk patients.

Spondylodiscitis

Nowadays, button battery ingestion accounts for one of the common foreign body ingestions among pediatric population. Unexpected manifestations in this setting, particularly after late removal, are confusing and might be misleading and postpone the proper management. We report a case of button battery ingestion in a 10-month-old boy who was primarily considered uncomplicated. However, he was readmitted with neck stiffness, which later turned to be due to spondylodiscitis. Based on this report, we strongly recommend considering spondylodiscitis as a late but serious complication of button battery ingestion in any patient who presents with restricted neck movement following foreign body ingestion.

Tracheoesophageal fistula following button battery ingestion: Successful non-operative management

The incidence of devastating complications from button battery ingestions is increasing. Battery impactions may result in erosive esophagitis, tracheoesophageal fistula (TEF), esophageal strictures, spondylodiscitis, vocal cord paralysis due to paralysis of recurrent laryngeal nerve(s), and aortoesophageal fistulas with significant morbidity and mortality. We present a case of a 15month old boy who developed an acquired TEF secondary to ingestion of a 20mm button battery lodged at the level of the carina. The clinical course and imaging findings are reviewed. Serial limited CT imaging with 3-D reconstruction was helpful in noninvasive assessment of healing and clinical decision making. Of special interest are the negative initial esophagram and the healing of the fistula without the need for surgical intervention.

Laparoscopic management of intestinal obstruction and perforation of Meckel's diverticulum by a button battery

We describe a case of intestinal obstruction and peritonitis secondary to an ingested button battery impacted and eroded in a Meckel's diverticulum. The patient had an uneventful recovery following a laparoscopic assisted retrieval of the button battery and Meckel's diverticulectomy with primary small bowel anastomosis. Impaction of a button battery in Meckel's diverticulum with small bowel obstruction and perforation of the diverticulum, is rare but potentially life threatening. Laparoscopy is very useful, safe and effective diagnostic and therapeutic tool.

When Button Batteries Become Breakfast: The Hidden Dangers of Button Battery Ingestion

Injuries due to button battery ingestion continue to evolve with worsening clinical outcomes reported in recent years. These batteries pose a unique hazard to children due to the severity of complications that may arise within a short period of time as well as their availability in almost every home environment in the United States. It is crucial that health care providers maintain a high level of clinical suspicion for foreign body ingestion and facilitate rapid triage and treatment in these cases. Nurses should educate all children and families about button battery safety to prevent injury and decrease the morbidity and mortality related to ingestion.

Impacted Button-Battery Masquerading as Croup

BackgroundForeign body ingestion is a frequent complaint in the Pediatric Emergency Department. ObjectiveButton-battery ingestion is discussed, with particular attention being given to its management. Case ReportHere is an interesting case of a button-battery ingestion by a 1-year-old boy with known asthma who presented to our Emergency Department. He presented in acute respiratory distress with signs of upper airway obstruction. Failing conventional therapy, a chest radiograph was obtained, which led to the diagnosis and subsequent removal. ConclusionThe management of a button-battery ingestion depends on the patient’s age, the presence or absence of symptoms, the size of the object, and location of the object within the gastrointestinal tract. In years past, every esophageal button battery required emergent endoscopic removal. But revised guidelines from the National Battery Ingestion Hotline at the National Capital Poison Center have adjusted this management, which is discussed.

The saga of a neglected foreign body in esophagus

An ingested foreign body lodged in the esophagus is common in children. Button batteries impacted in the esophagus need early diagnosis and intervention to avoid complication. We report a case of neglected button battery impacted in the upper esophagus in a 15-month-old female child. The problems encountered during the course of management have been discussed along with the review of the literature. Button battery ingestions in children need to be considered as an emergency and prompt endoscopic removal should be advocated. Rigid esophagoscopy is the gold standard technique of removing esophageal foreign bodies. Complication must be anticipated and managed at the earliest.

Bilateral vocal palsy following coin cell lithium battery ingestion: a case report and review

Button battery ingestion in children is not a rare occurrence and may be unwitnessed and can be soon life-threatening or responsible for severe sequelae. We report herein an original history of previously healthy 16-month-old boy with an unwitnessed and misdiagnosis of lithium cell coin battery ingestion which leads to bilateral vocal palsy. The patient underwent a unilateral posterior cordotomy and was successfully extubated. Early recognition of a lithium cell coin battery for rapid removal, even if insufficient at first, is the main condition to limit complications. Unusual upper respiratory distress in a young child should alert practitioners in performing a chest and neck X-ray without undue delay.

Button battery ingestion and insertion by children—an international approach to an emerging dangerous injury

The Seminar will include a variety of presenters, on behalf of• Product safety regulators—USA, Australia, New Zealand, Korea, Japan• Community organisations—Safe Kids Worldwide, Safe Kids USA, Safe Kids Canada, Safekids...

REGULATORY APPROACH TO BUTTON BATTERIES

The Australian Competition and Consumer Commission (ACCC) has been assessing the safety of lithium-cell button batteries since August 2010.Part of this assessment compared the Australian injury experience with published USA...

Regulatory approach to button batteries

Oral PresentationThe Australian Competition and Consumer Commission (ACCC) has been assessing the safety of lithium-cell button batteries since August 2010. Part of this assessment compared the Australian injury experience with...

Resident advocacy to mitigate hazards of button battery ingestions

BackgroundIn collaboration with selected faculty, the Office of Child Advocacy supports resident education in advocacy and mobilised an evidence-based response to mitigate hazards of button battery ingestions.ObjectivesWe aimed to improve...

Oesophageal complication from button battery ingestion in an infant

The substantial risks of button battery ingestion in children have been known to clinicians for some time. Modern button batteries are twice as large (20 mm rather than 10 mm) and twice as powerful (3 V rather than 1.5 V) as older batteries. Ingestion of modern batteries causes earlier and more severe tissue injury, as these larger batteries are more likely to impact at areas of physiological narrowing. A high index of suspicion for ingestion, use of appropriate imaging and early removal of batteries is necessary to prevent complications.

Disk Battery Aspiration in a Young Child

Disk (or button) battery ingestion is not uncommon, with an estimated US incidence of 2 to 8 per million annually.(1) Reported serious adverse sequelae include esophageal stenosis, tracheoesophageal fistula, vocal cord paralysis, massive bleeding, and death.(1,2) There are, however, surprisingly few reports of aspirated batteries in the searchable literature; we found only 2. We present the diagnostic workup and treatment of a previously healthy 4-year-old boy with an aspirated disk battery in the bronchus.

Survival of patient after aorto‐oesophageal fistula following button battery ingestion

Survival of patient after aorto‐oesophageal fistula following button battery ingestion

Hidden Attraction: A Menacing Meal of Magnets and Batteries

BackgroundMagnet and button battery ingestions are increasingly common, and can result in significant morbidity. Timely identification of hazardous foreign body ingestions can be difficult in non-verbal and non-disclosing children. ObjectivesWe aim to present a case that demonstrates some of the challenges around identifying and correctly locating magnets and batteries, and the importance of prompt identification and removal. Case ReportWe describe an older child with the covert ingestion of multiple magnets and batteries, with magnets that attracted across the stomach and a loop of jejunum. Mild symptoms and signs resulted in a delayed diagnosis and serious consequences. Radiographs suggested a gastric location of the foreign bodies. ConclusionHealth care workers should consider the possibility of battery or magnet ingestions in children with vomiting and abdominal pain, even when well-appearing. Like esophageal batteries, multiple gastrointestinal magnets and combined magnet-battery ingestions can cause significant morbidity, and prompt identification is important. Providers should ask verbal children for ingestion histories, and consider radiographs when symptoms are atypical or persistent. Like esophageal batteries, gastrointestinal magnet-battery ingestions should be removed promptly to prevent complications. Caregivers should supervise or limit the use of toys that include magnets and batteries.

Button battery ingestion: The greek experience and review of the literature

Button battery ingestion: The greek experience and review of the literature

Perforation of Meckel's diverticulum by a button battery: Report of two cases

Ingested button battery perforation of Meckel's diverticulum is extremely rare, with only two reported cases in the recent literature. Two additional preschool children who accidentally swallowed an alkaline button battery and developed a perforated Meckel's diverticulum are reported. Surgeons should be aware of this rare complication. Careful clinical, radiologic and laboratory monitoring of children who ingest a button battery is advisable.

Gastric Mucosal Damage From Ingestion of 3 Button Cell Batteries

Management of ingested button batteries, according to recently updated recommendations from the National Capital Poison Center, is based primarily on symptoms and where the batteries lodge. Batteries in the esophagus can cause life-threatening or even fatal complications including esophageal perforation (1,2), tracheo-esophageal fistulas (3,4), and hemorrhage from arterial fistulization (8). Injury is thought secondary to electrochemical burns from electrical discharge. Chemical burns from electrolyte alkali leakage and pressure necrosis also may contribute (5). Early endoscopic removal from the esophagus is thus advocated. In contrast, management when button batteries have passed the lower esophageal sphincter is less clear. Few cases of injury have been reported from button batteries distal to the esophagus (6,7). Indications for removal are not fully delineated. We report a case in which 3 ingested button batteries were removed from a young child’s stomach. Significant mucosal injury was found in the gastric body despite early intervention. Further information is needed to determine the clinical conditions under which button batteries lodged in the stomach warrant early extraction.

Pediatric Button Battery and Small Magnet Coingestion

Ingestion of button batteries and ingestion of 2 or more small magnets have both been increasingly recognized as having high potential for injury. Coingestion of a button battery and a small magnet has only rarely been described but has the potential for both ischemic injury due to the tight magnetic adherence and the electric current injury from the button battery. We report 2 cases of button battery and small magnet coingestion; one required surgical repair of an important bowel injury, while the other had a benign course. We discuss the management and role of radiography in these cases and the potential factors to consider when predicting which patients will have serious injury and which will do well.