Foreign Body Ingestion in Children: Should Button Batteries in the Stomach Be Urgently Removed?

Abstract

PurposeForeign body (FB) ingestion is common in children, and button battery (BB) ingestion has been increasing in recent years. This study was to identify factors related to outcomes of FB ingestion, particularly BBs in the stomach. We evaluated whether the current recommendations are appropriate and aimed to suggest indications for endoscopic removal of BB in the stomach in young children.MethodsWe investigated patient age, shape, size, location of FBs, spontaneous passage time and resulting complications among 76 children. We observed types, size, location of BB and outcomes, and analyzed their associations with complications.ResultsCoins and BB were the two most common FBs. Their shapes and sizes were not associated with the spontaneous passage time. Size, spontaneous passage time, and age were also not associated with any specific complications. For BB ingestion, all 5 cases with lithium batteries (≥1.5 cm, 3 V) presented moderate to major complications in the esophagus and stomach without any symptoms, even when the batteries were in the stomach and beyond the duodenum, while no complications were noted in 7 cases with alkaline batteries (<1.5 cm, 1.5 V) (p=0.001). All endoscopies were conducted within 24 hours after ingestion.ConclusionThe type and voltage of the battery should be considered when determining whether endoscopy is required to remove a BB in the stomach. For lithium battery ingestion in young children, urgent endoscopic removal might be important in order to prevent complications, even if the child is asymptomatic and the battery is smaller than 2 cm.

Foreign Body Ingestion in Children

“…Usually, small button batteries (diameter ≤20 mm) do not cause serious complications that are observed in association with larger button batteries (diameter ≥20 mm) [ 17 ]. A study has shown that all 7 children who ingested button batteries <15 mm in size were asymptomatic without any complications, whereas all 5 children who swallowed batteries >15 mm in size showed moderate ( n =3) to severe ( n =2) complications [ 18 ]. The author described a 13-month-old infant who had ingested a 15-mm sized button battery 24 hours prior to presentation.…”

Parental Awareness regarding Aerodigestive Pediatric Foreign Bodies, Eastern Province, Saudi Arabia

“…It's small, shiny and smooth object which attract most children who handle it. It contains materials that are strong enough to cause rapid liquefaction necrosis of tissue leading to serious complications such as perforation, mediastinitis, or even death [7,8]. Radiological investigations should be used to identify the object but not to exclude it.…”

Sharp foreign body ingestion by a young girl

“…Foreign body ingestion is an international problem among children starting from fishbone impaction which is more commonly observed in countries where fish is the main dietarysnack 1 to large object that lead to esophageal perforation. 2 Some foreign bodies need urgent removal like button batteries 3 while others remains dormant for years like in this case. At times FB ingestion is intentional and at others it is accidental.…”