The Hazard of Ingested Alkaline Disk Batteries in Children

Votteler, Theodore P.

doi:10.1001/jama.1983.03330420050034

Cited by 105 publications

(53 citation statements)

References 5 publications

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“…Animal experiments confirm the rapid onset of severe injury observed in humans. 13,15,47 Delays introduced by late presentation, misdiagnosis, limited access to endoscopists, referral to a tertiary care facility, or concern about anesthesia induction after eating undoubtedly contributed to the severity of complications. Hemorrhage occurred in 12 of the 13 deaths, and no reported patients with massive delayed hemorrhage survived.…”

Section: Nbih and Medical Literature: Clinical Issues And The Urgencymentioning

confidence: 99%

Emerging Battery-Ingestion Hazard: Clinical Implications

et al. 2010

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OBJECTIVES: Recent cases suggest that severe and fatal button battery ingestions are increasing and current treatment may be inadequate. The objective of this study was to identify battery ingestion outcome predictors and trends, define the urgency of intervention, and refine treatment guidelines. METHODS: Data were analyzed from 3 sources: (1) National Poison Data System (56535 cases, 1985–2009); (2) National Battery Ingestion Hotline (8648 cases, July 1990–September 2008); and (3) medical literature and National Battery Ingestion Hotline cases (13 deaths and 73 major outcomes) involving esophageal or airway button battery lodgment. RESULTS: All 3 data sets signal worsening outcomes, with a 6.7-fold increase in the percentage of button battery ingestions with major or fatal outcomes from 1985 to 2009 (National Poison Data System). Ingestions of 20- to 25-mm-diameter cells increased from 1% to 18% of ingested button batteries (1990–2008), paralleling the rise in lithium-cell ingestions (1.3% to 24%). Outcomes were significantly worse for large-diameter lithium cells (≥20 mm) and children who were younger than 4 years. The 20-mm lithium cell was implicated in most severe outcomes. Severe burns with sequelae occurred in just 2 to 2.5 hours. Most fatal (92%) or major outcome (56%) ingestions were not witnessed. At least 27% of major outcome and 54% of fatal cases were misdiagnosed, usually because of nonspecific presentations. Injuries extended after removal, with unanticipated and delayed esophageal perforations, tracheoesophageal fistulas, fistulization into major vessels, and massive hemorrhage. CONCLUSIONS: Revised treatment guidelines promote expedited removal from the esophagus, increase vigilance for delayed complications, and identify patients who require urgent radiographs.

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Section: Nbih and Medical Literature: Clinical Issues And The Urgencymentioning

confidence: 99%

Emerging Battery-Ingestion Hazard: Clinical Implications

et al. 2010

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“…Thus, they recommend that the battery should be removed with a magnet or by other means while it is within the stomach, since necrosis extending to the mucous layer mayoccur, if the battery strays off into, for instance, the diverticulum to become fixed there for over 8 hours, followed by collapse of the battery more than 72 hours after, resulting in a possible alkaline leakage (1 ). Votteler et al, who inserted a 1.5 V battery into dog esophagus, noted ulcer formation after 2 hours (20). These findings thus suggest that batteries should be quickly recovered if they are located within the esophagus or stomach.…”

Section: Discussionmentioning

confidence: 92%

Device for the Removal of Button Batteries.

Yamauchi¹,

Kobayashi²,

Shinomiya³

et al. 2001

Intern. Med.

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Objective There is an increasing numberof accidents by erroneous ingestion of button batteries in recent years; the batteries arouse the interest of infants because of their attractive shape and luster. The batteries remaining in the gastrointestinal tract and discharging electric current over a long period of time may induce ulceration or perforation, Results Weeasily removed button batteries from the stomach within 5 minutes in all cases with two magnet-attached tubes. Conclusion Wepresent this battery removal device together with a literature review,because it seems convenient and useful. (Internal Medicine 40: 9-13, 2001)

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“…Pillerin yutulması ve olgu sayısı giderek önemli ölçüde artmaktadır (20). Yemek borusunda açıldığında önemli morbidite nedenidir, bu yüzden tıbbi acil durum olarak kabul edilir.…”

Section: Discussionunclassified