Catastrophic haemorrhage from button battery ingestion in children: a growing problem

Wright, Katie; Parkins, K; Jahn, Haiko Kurt; Rowlands, Rachel; Davies, Ffion

doi:10.1111/apa.13934

Cited by 11 publications

(4 citation statements)

References 8 publications

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“…According to the NCPC, 251 nonfatal BB ingestion cases with severe esophageal or airway injury have been reported 49 . Importantly, complications often present in a delayed fashion with bleeding events reported weeks after BB removal 1,24,50 . Other complications such as esophageal stricture and perforation, spondylodiscitis, and tracheoesophageal fistula have been reported to present weeks to months later with some cases as late as 6 to 8 months following BB ingestion 24,49 .…”

Section: Clinical Considerationsmentioning

confidence: 99%

Current management of button battery injuries

Sethia

Gibbs

Jacobs

et al. 2021

Laryngoscope Investig Oto

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Button batteries (BB) are found in common household items and can lead to significant morbidity and mortality in the pediatric population when ingested. BBs are made of various chemistries and have a unique size and shape that yield significant injury when lodged in the pediatric esophagus. BBs create a local tissue pH environment of 10 to 13 and can induce liquefactive necrosis at the negative pole. This initial injury can progress with further tissue breakdown even after removal. Unfortunately, patients may present with vague symptoms similar to viral illnesses and there is not always a known history of ingestion. Plain film X‐ray can be diagnostic. Exposure can lead to caustic injury within 2 hours. Thus, timely endoscopic removal is the mainstay of treatment. Novel mitigation and neutralization strategies have been implemented into treatment guidelines. These include the preremoval ingestion of honey or sucralfate and intraoperative irrigation with acetic acid. Depending on the severity of injury following removal, careful consideration should be given for potential delayed complications including fistulization into major vessels which often leads to death. The National Button Battery Taskforce and several industry members have implemented prevention strategies such as educational safety outreach campaigns, child‐resistant packaging changes, and warning labels. Governmental regulation and industry changes are key to limit not only the amount of BB ingestions, but also the devastating consequences that can result. Anonymous reporting of BB injuries through the Global Injury Research Collaborative has been made convenient and centralized through the advent of a user‐friendly smartphone iOS/App Store and Android/GooglePlay application called the “GIRC App”; all specialists who manage foreign body cases should contribute their cases to help prevent future injuries. BB ingestion must be recognized and treated promptly using a multidisciplinary approach to optimize outcomes for these patients. Ultimately, a safer BB technology is critically needed to reduce or eliminate the severe and life‐threatening injuries in children. Level of Evidence 5

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Section: Clinical Considerationsmentioning

confidence: 99%

Current management of button battery injuries

Sethia

Gibbs

Jacobs

et al. 2021

Laryngoscope Investig Oto

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“…Leakage of alkaline electrolyte and pressure necrosis are no longer thought to be significant factors in causing severe tissue damage. Complications from tissue injury and necrosis are well known to occur after removal of the BB, with delayed bleeding events reported up to 27 days postremoval and esophageal perforations up to 48 days postremoval (10,11).…”

mentioning

confidence: 99%

Mitigating Risks of Swallowed Button Batteries

Lerner

Brumbaugh

Lightdale

et al. 2020

J. pediatr. gastroenterol. nutr.

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Despite ongoing efforts of the national Button Battery Task Force (BBTF), cases of major morbidity and mortality continue to be reported at a higher rate after ingestion of higher voltage and larger button batteries. Initiation of sucralfate or honey shortly after some button battery ingestions is crucial to prevent further injury while awaiting emergent removal. Endoscopic acetic acid irrigation post removal of button battery may halt deeper injury. Gastroenterologists need to be aware of the updates to the National Capital Poison Center algorithm for button battery ingestion.

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“…The resultant damage could at times be fatal, depending on the site of lodgement 3. Among the various prognostic factors predicting long-term morbidity due to button battery insertion, ‘the time since impaction’ remains one of the important factor 5.…”

Section: Discussionmentioning

confidence: 99%

Usual suspects: the foreign bodies of the aerodigestive tract

Devaraja¹,

Nayak

Bhandarkar

et al. 2018

BMJ Case Reports

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This case series is about four different foreign bodies lodged in different locations of the aerodigestive tract. All four cases had delayed diagnosis due to inconspicuous history. Radiology in the form of computed tomography aided the appropriate diagnosis in most of these cases. Though all four patients have been successfully managed by removal of foreign body, not all of them have identical outcomes. A brief discussion about predictive factors in the fish bone foreign body has been included. The authors also discuss certain critical aspects of the management, which may aid in reducing the morbidity. We emphasise on the high index of suspicion in peculiar cases and on the low threshold for radiological investigation in doubtful clinical scenarios.

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Catastrophic haemorrhage from button battery ingestion in children: a growing problem

Cited by 11 publications

References 8 publications

Current management of button battery injuries

Current management of button battery injuries

Mitigating Risks of Swallowed Button Batteries

Usual suspects: the foreign bodies of the aerodigestive tract

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