Button Battery Foreign Bodies in Children: Hazards, Management, and Recommendations

Abstract

Objective. The demand and usage of button batteries have risen. They are frequently inadvertently placed by children in their ears or noses and occasionally are swallowed and lodged along the upper aerodigestive tract. The purpose of this work is to study the different presentations of button battery foreign bodies and present our experience in the diagnosis and management of this hazardous problem in children. Patients and Methods. This study included 13 patients. The diagnostic protocol was comprised of a thorough history, head and neck physical examination, and appropriate radiographic evaluation. The button batteries were emergently extracted under general anesthesia. Results. The average follow-up period was 4.3 months. Five patients had a nasal button battery. Four patients had an esophageal button battery. Three patients had a button battery in the stomach. One patient had a button battery impacted in the left external ear canal. Apart from a nasal septal perforation and a tympanic membrane perforation, no major complications were detected. Conclusion. Early detection is the key in the management of button battery foreign bodies. They have a distinctive appearance on radiography, and its prompt removal is mandatory, especially for batteries lodged in the esophagus. Physicians must recognize the hazardous potential and serious implications of such an accident. There is a need for more public education about this serious problem.

How did that get there? A population‐based analysis of nasal foreign bodies

“…1,2 Furthermore, the potential for several injuries specific to particular foreign bodies make expeditious identification exceedingly important. For example, objects such as sharp items or consumer products containing dangerous chemicals, such as batteries, require extra vigilance.…”

Vaginal Burn from Alkaline Battery in an 8-Year-Old

“…Expeditious (within 2 hours) removal of ingested/inserted button batteries is necessary, with increased risk of severe or fatal outcome also related to the type of battery (lithium more damaging than alkaline owing to electrolysis of tissue or mucosal fluid versus leakage), size of the battery (O20 mm), and age of the patient (!4 y). 1,2 Unfortunately in our patient's case exposure could have been ameliorated as she presented to another institution's ED immediately following the incident but was discharged home to return the next day because radiography was unavailable.…”

Button Battery Ingestion in Children

“…In general, any child presenting to the ED with symptoms consistent with a foreign body should have both anteroposterior and lateral films of the chest and airway to help differentiate the ubiquitous coin ingestions from BB. 19 Careful examination of these films for the halo sign, as well as the step-off between the positive and negative nodes of BBs, should be performed. If a BB is found, orientation of the slightly smaller negative pole (anode) should be noted, as this is the direction of most serious injury.…”