Button battery ingestion: Hazards of esophageal impaction

doi:10.1016/S0022-3468(99)90119-7

Journal of Pediatric Surgery

Volume 34, Issue 10, October 1999, Pages 1527-1531

https://doi.org/10.1016/S0022-3468(99)90119-7 Get rights and content

Abstract

Ingestion of button batteries has been seen with increasing frequency over the past decade^1,2. In a small number of reported cases, their impaction in the esophagus has led to serious, sometimes fatal, complications. The management of these cases has varied from expectant, supportive therapy to early surgical intervention. The authors report 2 pediatric patients in whom esophageal perforation developed after impaction of a disc battery. Both were treated conservatively with successful outcomes.

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The purpose of this study was to analyze the management and outcomes of primary button battery ingestions and their sequelae at a single high-volume center, and to propose a risk score to predict the likelihood of a severe outcome.
The medical record was queried for all patients under 21 years old evaluated at our institution for button battery ingestion from 2008 to 2021. A severe outcome was defined as having at least one of the following: deep/circumferential mucosal erosion, perforation, mediastinitis, vascular or airway injury/fistula, or development of esophageal stricture. From a selection of clinically relevant factors, logistic regression determined predictors of a severe outcome, which were incorporated into a risk model.
143 patients evaluated for button battery ingestion were analyzed. 24 (17%) had a severe outcome. The independent predictors of a severe outcome in multivariate analysis were location of battery in the esophagus on imaging (96%), battery size >/ = 2 cm (95%), and presence of any symptoms on presentation (96%), with P < 0.001 in all cases. Predicted probability of a severe outcome ranged from 88% when all three risk factors were observed, to 0.3% when none were present.
We report the presentation, management, and complication profiles of a large cohort of BB ingestions treated at a single institution. A risk score to predict severe outcomes may be used by providers initially evaluating patients with button battery ingestion in order to allocate resources and expedite transfer to a center with pediatric endoscopic and surgical capabilities.
Level IV.
Clinical Research Paper.
Fatal haemorrhage from an aortoesophageal fistula secondary to button battery ingestion in a 15-month-old child. Case report and literature review
2020, Legal Medicine
Small children put various objects into their mouths, which is one of their ways of exploring the surrounding world. Apart from toy parts, e.g. Lego® bricks or magnetic spheres, such objects include coins, small stones, as well as batteries used for different electric devices. Such batteries, especially the flat, round button type, may be ingested and become impacted in one of the physiological narrowing sites of the oesophagus, leading to serious complications.
The case of a 15-month-old child is presented, who died due to a massive gastrointestinal haemorrhage from an aortoesophageal fistula that developed at the site of a pressure ulcer caused by an impacted button battery.
The presented case shows that ingestion of even a small battery may lead to death. The asymptomatic course of the battery ingestion significantly hinders both the assessment of circumstances and the time of the battery ingestion. Sudden death may result from a massive haemorrhage from a pressure-induced injury to a big blood vessel.
Metals extraction from waste button cell battery
2020, Current Developments in Biotechnology and Bioengineering: Resource Recovery from Wastes
Button or coin cells are the sources of energy in various electronic gadgets like wristwatches, pocket calculators, medical devices, and hearing aids. Its market is increasing day by day with technological advancement and the need for prototypes. The button cells are primary batteries those are nonrechargeable and involve different combinations of lithium, zinc–air, alkaline, and silver oxide. Its resultant waste may consist of heavy metals such as Zn, Pb, Hg, Co, Ag, Li, etc. and organic chemicals present as binder, adhesive, insulator, etc. The landfilling of batteries can cause severe pollution problems and depletion of worldwide reserves of metal ores. Technologies involved for the recovery of metals from button cells include pyrometallurgy, hydrometallurgy, biometallurgy, and leaching. A critical assessment of scientific technologies available for the recovery of metals needs serious evaluation to develop a less toxic, economically viable, and environmentally sound process.
Button Battery Safety: Industry and Academic Partnerships to Drive Change
2019, Otolaryngologic Clinics of North America
Battery ingestions in children: Variations in care and development of a clinical algorithm
2018, Journal of Pediatric Surgery
To review current management and outcomes of ingested batteries and develop a clinical management algorithm.
Children < 18 years old who ingested a battery between 1/2011 and 9/2016 at two tertiary care children's hospitals were reviewed. Demographics, imaging, management and outcomes were analyzed using descriptive statistics, Chi-square and Wilcoxon Rank-sum tests.
There were 180 battery ingestions. The median age was 3.9 (range 0.7–18) years, with 78 (43%) males. The most common symptoms were abdominal pain (17%) and nausea/vomiting (14%). Diagnosis was confirmed with plain radiographs in 170 (94%) patients. Locations on imaging were: stomach (37%), small bowel (24%), esophagus (18%), colon (11%), and non-specific location past the gastroesophageal junction (9%). Treatment was dictated by five different subspecialties including surgery (35%), gastroenterology (25%), emergency medicine (19%), primary care/emergency with a consulting service (13%), and otolaryngology (8%).
All esophageal batteries (n = 33) had an intervention. Interventions included fluoroscopic balloon extraction (6 attempted, 33% retrieval rate), rigid esophagoscopy (26 attempted, 96% retrieval rate), and EGD (6 attempted, 83% retrieval rate).
For batteries distal to the gastroesophageal junction 16 (11%) patients had an intervention. Interventions included EGD (13 patients, 69% retrieval), colonoscopy (1 patient, successful retrieval), and abdominal surgery in two patients.
Isolated batteries that pass the gastroesophageal junction rarely require intervention and can be managed conservatively. Given the variability in managing these patients, we developed an evidence based algorithm.
Level 2.
Retrospective Study.

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Case reportButton battery ingestion: Hazards of esophageal impaction

Abstract

J Paediatr Surg

J Pediatr Surg

Ann Emerg Med

Ingestion of cylindrical and button batteries: An analysis of 2382 cases

Pediatrics

Button battery ingestions: A review of 56 cases

JAMA

The hazard of ingested alkaline disc batteries in children

JAMA

Button battery in the nose—An unusual foreign body

J Laryngol Otol

Button batteries in the ear, nose and cervical esophagus: A destructive foreign body

J Otolaryngol

Disk battery ingestion

JAMA

Esophageal perforation after button battery ingestion

Ann R Coll Surg Eng

Case report
Button battery ingestion: Hazards of esophageal impaction