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Severe esophageal damage due to button battery ingestion: can it be prevented?

Abstract

Batteries represent less than 2% of foreign bodies ingested by children, but in the last 2 decades, the frequency has continuously increased. Most ingestions have an uneventful course, but those that lodge in the esophagus can lead to serious complications and even death. Medline was used to search the English medical literature, combining “button battery” and “esophageal burn” as keywords. Cases were studied for type, size, and source of the batteries; duration and location of the battery impaction in the esophagus; symptoms; damage caused by the battery; and outcome. Nineteen cases of esophageal damage have been reported since 1979.Batteries less than 15 mm in diameter almost never lodged in the esophagus. Only 3% of button batteries were larger than 20 mm but were responsible for the severe esophageal injuries in this series. These data suggest that manufacturers should replace large batteries with smaller ones and thus eliminate most of the complications. When the battery remains in the esophagus, endoscopic examination and removal done urgently will allow assessment of the esophageal damage, and treatment can be tailored accordingly. There is a need for more public education about the dangers of battery ingestion; this information should be included as part of the routine guidelines for childproofing the home.

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References

  1. 1.

    Litovitz T, Schmitz B.F (1992) Ingestion of cylindrical and button batteries: an analysis of 2382 cases. Pediatrics 89:747–757

    CAS  PubMed  Google Scholar 

  2. 2.

    Thompson N, Lowe-Posford F, Mant TGK, Volans GN (1990) Button battery ingestion: a review. Acute Poisoning Rev 9:157–182

    CAS  Google Scholar 

  3. 3.

    Sheikh A (1993) Button battery ingestions in children. Pediatr Emerg Care 9:224–229

    CAS  PubMed  Google Scholar 

  4. 4.

    Cheng W, Tam PKH (1999) Foreign-body ingestion in children: experience with 1265 cases. J Pediatr Surg 34:1472–1476

    CAS  PubMed  Google Scholar 

  5. 5.

    Janik JS, Burrington JD, Wayne ER, Foley LC (1982) Alkaline battery ingestion. Colo Med 79:404–405

    CAS  PubMed  Google Scholar 

  6. 6.

    Van Asperen PP, Seeto I, Cass DT (1986) Acquired tracheo-oesophageal fistula after ingestion of a mercury button-battery. Med J Aust 145:412–415

    PubMed  Google Scholar 

  7. 7.

    McNicholas K, Stark J (1984) Unusual case of benign tracheo-oesophageal fistula. Thorax 39:311–312

    CAS  PubMed  Google Scholar 

  8. 8.

    Sigalet D, Lees G (1988) Tracheoesophageal injury secondary to disc battery ingestion. J Pediatr Surg 23:996–998

    CAS  PubMed  Google Scholar 

  9. 9.

    Senthilkumaran G, Crankson S, Yousef M (1996) Spontaneous closure of acquired tracheo-oesophageal fistula. J Larygnol Otol 110:685–687

    CAS  Google Scholar 

  10. 10.

    Kost KM, Shapiro RS (1987) Button battery ingestion: a case report and review of the literature. J Otolaryngol 16:252–257

    CAS  PubMed  Google Scholar 

  11. 11.

    Shabino CL, Feinberg AN (1979) Esophageal perforation secondary to alkaline battery ingestion. JACEP 8:360–363

    CAS  PubMed  Google Scholar 

  12. 12.

    Rivera EA, Maves MD (1987) Effects of neutralizing agents on esophageal burns caused by disc batteries. Ann Otol Rhinol Laryngol 96:362–366

    CAS  PubMed  Google Scholar 

  13. 13.

    Votteler TP, Nash JC, Rutledge JC (1983) The hazard of ingested alkaline disk batteries in children. JAMA 249:2504–2505

    Article  CAS  PubMed  Google Scholar 

  14. 14.

    Gordon AC, Gough MH (1993) Oesophageal perforation after button battery ingestion. Ann R Coll Surg Engl 75:362–364

    CAS  PubMed  Google Scholar 

  15. 15.

    Vaishnav A, Spitz L (1989) Alkaline battery-induced tracheo-oesophageal fistula. Br. J Surg 76:1045

    CAS  PubMed  Google Scholar 

  16. 16.

    Litovitz TL (1985) Battery ingestions: product accessibility and clinical course. Pediatrics 75:469–476

    CAS  PubMed  Google Scholar 

  17. 17.

    Millar AJW, Rode H, Cywes S (1985) Button-battery ingestions—a hazard of modern living. S Afr Med J 68:868–871

    CAS  PubMed  Google Scholar 

  18. 18.

    Bass DH, Millar AJW (1992) Mercury absorption following button battery ingestion. J Pediatr Surg 27:1541–1542

    CAS  PubMed  Google Scholar 

  19. 19.

    Mant TG, Lewis JL, Mattoo TK, Rigden SP, Volans GN, House IM, Wakefield AJ, Cole RS (1987) Mercury poisoning after disc-battery ingestion. Hum Toxicol 6:179–181

    CAS  PubMed  Google Scholar 

  20. 20.

    Crysdale WS, Sendi KS, Yoo J (1991) Esophageal foreign bodies in children. 15-year review of 484 cases. Ann Otol Rhinol Laryngol 100:320–324

    Google Scholar 

  21. 21.

    Temple DM, McNeese MC (1983) Hazards of battery ingestion. Pediatrics 71:100–103

    CAS  PubMed  Google Scholar 

  22. 22.

    Yamashita M, Saito S, Koyama K, Hattori H, Ogata T (1987) Esophageal electrochemical burn by button-type alkaline batteries in dogs. Vet Hum Toxicol 29:226–230

    CAS  PubMed  Google Scholar 

  23. 23.

    Nandi P, Ong GB (1978) Foreign body in the oesophagus: review of 2394 cases. Br J Surg 65:5-9

    CAS  PubMed  Google Scholar 

  24. 24.

    Willis GA, Ho WC (1982) Perforation of Meckel’s diverticulum by an alkaline hearing aid battery. Can Med Assoc J 126:497–498

    CAS  PubMed  Google Scholar 

  25. 25.

    Yee KF, Schild JA, Holinger PH (1975) Extraluminal foreign bodies (coins) in the food and air passages. Ann Otol Rhinol Laryngol 84:619–623

    CAS  PubMed  Google Scholar 

  26. 26.

    Samad L, Ali M, Ramzi H (1999) Button battery ingestion: hazards of esophageal impaction. J Pediatr Surg 34:1527–1531

    CAS  PubMed  Google Scholar 

  27. 27.

    Tanaka J, Yamashita M (1998) Esophageal electrochemical burns due to button type lithium batteries in dogs. Vet Hum Toxicol 40:193–196

    CAS  PubMed  Google Scholar 

  28. 28.

    Blantik DS, Toohill RJ, Lehman RH (1977) Fatal complication from an alkaline battery foreign body in the esophagus. Ann Otolaryngol 86:611–615

    Google Scholar 

  29. 29.

    Maves MD, Carithers JS, Birck HG (1984) Esophageal burns secondary to disc battery ingestion. Ann Otol Rhinol Laryngol 93:364–369

    CAS  PubMed  Google Scholar 

  30. 30.

    Easom JM (1982) Risks from swallowing small alkaline batteries. Pediatr Alert 7:21–22

    Google Scholar 

  31. 31.

    Kuhns DW, Dire JD (1989) Button battery ingestions. Ann Emerg Med 18:293–300

    CAS  PubMed  Google Scholar 

  32. 32.

    McDermott VGM, Taylor T, Wyatt JP, MacKenzie S, Hendry GMA (1995) Orogastric magnet removal of ingested disc batteries. J Pediatr Surg 30:29–32

    CAS  PubMed  Google Scholar 

  33. 33.

    Ito Y, Ihara N, Sohma S(1985) Magnetic removal of alkaline batteries from the stomach. J Pediatr Surg 3:250–251

    Google Scholar 

  34. 34.

    Kulig K, Rumack CM, Rumack BH, Duffy JP (1983) Disk battery ingestion. JAMA 249:2502–2503

    Article  CAS  PubMed  Google Scholar 

  35. 35.

    Litovitz TL (1983) Button battery ingestions: a review of 56 cases. JAMA 249:2495–2500

    Article  CAS  PubMed  Google Scholar 

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Correspondence to D. Yardeni.

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Yardeni, D., Yardeni, H., Coran, A.G. et al. Severe esophageal damage due to button battery ingestion: can it be prevented?. Ped Surgery Int 20, 496–501 (2004). https://doi.org/10.1007/s00383-004-1223-6

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Keywords

  • Button battery
  • Esophageal burn