Esophageal lesions following button-battery ingestion in children: Analysis of causes and proposals for preventive measures

Eur Ann Otorhinolaryngol Head Neck Dis. 2018 Apr;135(2):91-94. doi: 10.1016/j.anorl.2017.09.004. Epub 2017 Oct 18.

Abstract

Objectives: To study recent cases of esophageal injury due to button-battery ingestion in children presenting in pediatric ENT emergency departments of the Paris area of France (Île-de-France region), in order to propose appropriate preventive measures.

Material and method: A retrospective descriptive single-center study included all children under 15 years of age, presenting in pediatric ENT emergency departments between January 2008 and April 2014 for button-battery ingestion with esophageal impaction requiring emergency removal.

Results: Twenty-two boys and 4 girls, with a median age of 25 months, were included. Twenty-five of the 26 batteries had diameters of 20mm or more. Median esophageal impaction time was 7 hours 30 minutes (range, 2 to 72 hours). The complications rate was 23%. Mean hospital stay cost was €38,751 (range, €5130-119,737). The origin of the battery was known in 23 of the 26 cases: remote control without screw-secured compartment (42.3%), open battery pack (15.4%), children's toy (15.3%), camera (7.7%), watch (1 case) and hearing aid without screw-secured compartment (1 case).

Conclusion: Esophageal lesions due to ingestion of button-batteries in children are almost always due to batteries larger than 20mm in diameter, mostly from devices with a poorly protected compartment, or batteries that are not individually packaged. These lesions cause serious complications in a quarter of cases and their management entails high health costs. Legislation requiring screw-secured compartments and individual blisters for batteries could have prevented 69.2% of the ingestions.

Keywords: Button-battery; Esophagus; Foreign body; Pediatric.

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Eating*
  • Electric Power Supplies / adverse effects*
  • Emergencies / economics
  • Emergencies / epidemiology*
  • Emergency Service, Hospital
  • Esophagus / injuries*
  • Esophagus / surgery
  • Female
  • Foreign Bodies / complications
  • Foreign Bodies / economics
  • Foreign Bodies / epidemiology
  • Foreign Bodies / therapy*
  • France / epidemiology
  • Hospitals, Pediatric
  • Humans
  • Infant
  • Length of Stay
  • Male
  • Paris
  • Retrospective Studies
  • Risk Factors