Button Battery Injuries in the Pediatric Aerodigestive Tract

Abstract

Children with a button battery impaction present with nonspecific symptoms that may account for a delay in medical care. We conducted a retrospective study of the clinical presentation, management, and complications associated with button battery ingestion in thepediatric aerodigestive tract and to evaluate the associated longterm morbidity. We reviewed the medical records of 23 patients who were treated for button battery impaction at our tertiary care children's hospitalfrom Jan. 1,2000,. through July 31,2013. This population was made up of 14boys and 9 girls, aged 7 days to 12 years (mean: 4 yr). Patients were divided into three groups based on the site of impaction; there were 9 impactions in the esophagus and 7 each in thenasal cavity andstomach. We compiled information on thetypeandsizeofeach battery, theduration of the impaction, presenting symptoms, treatment, and outcomes. The mean duration of battery impaction was 40.6, 30.7, and 21.0 hours in the esophagus, nasal cavity, andstomach, respectively. We wereable toidentify the specific type of battery in 13 cases; 11 of these cases (85%) involved a 3-V 20-mm lithium ionbattery, including all cases of esophageal impaction in which the type of battery was identified. The most common presenting signs and symptoms were vomiting (n =7 (30%j), difficultyfeeding (n = 5 [22%]), cough (n = 5), and bloody

Identifying predictive factors for long-term complications following button battery impactions: A case series and literature review

“…Wurzel et al also endorses early interval bronchoscopy to monitor tracheal mucosal healing for batteries lodged specifically in the airway [7]. However, the lack of immediate visual evidence of extensive injury at time of initial removal does not rule out more serious follow-on injury [16]. Thus, there remains a need for additional factors to consider when managing patients after initial removal.…”

Injury Mechanism of Button Batteries in the Nasal Cavity and Possible Mitigation Strategies During Impaction

“…Nasal BB impaction occurs more frequently than esophageal and can cause septal necrosis and perforation, synechia, and long-term sequelae, such as saddle nose deformity. [1][2][3][4][5][6][7][8][9][10][11][12] Lou reported that septal perforation developed in seven of nine BB cases. They speculated that in the two other cases that did not develop septal perforation, weak acidic seawater spray had been used, and this neutralized the alkaline effect of the BBs.…”

“…Nevertheless, the fact that aspiration has the potential to cause a nasal foreign body to become a bronchial foreign body should be kept in mind. 1,8,9 The esophagus has room for a lodged battery for a mitigation fluid to move around it and help protect the mucosa. In the nasal cavity, where a rigid cartilaginous septum and turbinate bone are more tightly pressed around the battery, the ability to get fluids around and in between are quite limited.…”

“…Foreign body impaction in the upper aerodigestive tract is a common problem in the pediatric population under 6 years of age. [1][2][3] Button batteries (BBs) are a special subgroup because they can cause more serious complications than the other foreign bodies that are usually safely removed. 3 It has been reported that serious complications and fatal injuries related to BBs have increased ninefold in the past 20 years because of the rapid rise in the use of these batteries in electronic devices, especially toys.…”

An uncommon source for oesophageal foreign body: Fidget spinner

“…The lack of visual evidence of extensive injury at the time of removal does not rule out potential future injury. 13 Therefore, a repeat oesophagoscopy is recommended for disc battery impaction duration greater than 2–3 h, an impacted battery located close to the aorta, a battery with greater than 1.5 V, or concern for heavy metal or lithium toxicity. 14 A long-term sequelae of the ingested disc battery was not seen in our patient due to short duration of exposure to disc battery.…”