Management of Complication Developing Three Button Battery Swallowing Cases in Pediatric Emergency Department (original) (raw)

Button Battery (BB) Ingestion in Children: A Case Report

Bangladesh Journal of Child Health

Over the last few years, there is a rise in the use of button batteries(BB) in children’s toys and home appliances. Easy availability and small size of these batteries pose a significant risk of ingestion by small children which is exceedingly dangerous. After ingestion, the BB may lodge in the esophagus or enters easily into the stomach due to its variable sizes. If lodged in the esophagus, BB can cause injury due to their caustic and electric properties, as well as by direct pressure. In our case, the 16 months old boy had accidentally ingested a BB, removed approximately after 30 hours from the esophagus, had developed esophageal perforation followed by tracheaesophageal fistula, complications related to aspiration and finally expired due to bronchopneumonia with septicemia and respiratory failure. So, Prompt removal is mandatory to reduce devastating outcome if it is a button battery BANGLADESH J CHILD HEALTH 2021; VOL 45 (1) : 41-44

Button Battery Ingestion: A Conundrum of Preventable Sequelae Management

JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH, 2019

A one-year-old child presented to the emergency outpatient department with reduced appetite, foul-smelling vomitus and alleged history of ingestion of a button battery from a television remote ten days before the hospital visit. ENT examination was normal. Radiography of the neck-anteroposterior view revealed a radio-opaque foreign body with double rim appearance in the cricopharynx with surrounding soft tissue oedema [Table/ Fig-1]. The child was immediately taken up for emergency rigid hypopharyngoscopy and foreign body removal under general anaesthesia within two hours of presentation to the hospital. Intraoperatively, a 20 mm, 3V Lithium button battery was identified at the level of the cricopharynx, 16 cm from the upper incisor, covered with slough [Table/Fig-2]. On removal of the foreign body, there was mucosal erosion with no evidence of perforation or bleeding. A nasogastric tube was inserted intra-operatively in view of the mucosal erosion. Immediate to post-operative period the child was kept nil per oral. Nasogastric tube aspirate showed brownish blood stained content, which turned clear in two days. The child was transferred to the Paediatric Intensive Care Unit for observation. On post-operative Day 3, the child developed an episode of seizure associated with minor bleeding from the nose and mouth. Blood investigations revealed hyponatremia and hypocalcaemia. The seizures were attributed to the same and were corrected, and the child showed clinical improvement without further episodes of seizures or bleeding. The child was asymptomatic and hence was started on oral feeds on post-operative Day 6. Child tolerated the oral feeds well. On post-operative Day 8, the child developed an episode of generalised tonic-clonic seizures associated with massive haematemesis, haematochezia and epistaxis leading to hypovolemic shock and cardiac arrest. Spontaneous circulation was achieved with cardiopulmonary resuscitation. However, the child continued to have persistent massive bleeding from the oral cavity, nose and rectum with abdominal distension. An Aorto-oesophageal fistula was suspected. Before intervention for the same, the child succumbed due to massive bleeding. Case 2 A one-year-old child presented with complaints of two episodes of bloodstained vomitus following ingestion of a button battery from a toy, nine hours before presenting to the hospital. ENT examination was normal. A radiograph of the neck-anteroposterior view revealed a circular radio-opaque foreign body with a double rim appearance, suggestive of a button battery at the level of C3-C4 [Table/Fig-3]. The child was immediately taken up for emergency rigid hypopharyngoscopy and foreign body removal

Button battery ingestion in children: An emerging hazard

Journal of Digestive Endoscopy, 2013

Button battery ingestion is an emerging hazard. In this retrospective study, we report six cases of lithium button battery ingestion in pediatric age group (mean age 2.8 years). Three button batteries were removed from stomach and three from esophagus. Esophageal site was associated with significant local injury, and one button battery was impacted in the esophagus, requiring rigid esophagoscopy for removal. Small battery size, used batteries, and early removal (<12 h after ingestion) were associated with lesser mucosal injury. No long-term complications were noted. Our study emphasizes that early diagnosis and urgent removal of ingested button battery are the only measures which prevent complications.

Button battery ingestion: A therapeutic dilemma and clinical issues in management

Journal of the Scientific Society, 2016

Button batteries, also known as disc batteries, are tiny, round batteries commonly present in numerous household electronic gadgets such as watches, calculators, cameras, hearing aids, penlights, remote control devices, and certain toys. Because of their easy accessibility to children, they pose a serious menace of accidental ingestion or inhalation. Most of the ingestions are benign. However, large-sized button batteries when ingested can become impacted in the esophagus or elsewhere in the gastrointestinal tract with life-threatening repercussions. We report a 4-year-old female child brought to our setup by her parents with an alleged history of ingestion of a button battery of the watch approximately about 2 h back. The child, apart from being anxious, was asymptomatic. An initial radiograph of the chest and abdomen was taken, which showed the battery at the distal end of the stomach. Considering the small size of the battery cell and after seeking the gastroenterologist's consultation, it was decided that the child would be managed conservatively with oral antacids and serial abdomen skiagrams were obtained. The button battery was eventually detected in the stools after 2 days.

Button battery ingestion- case report and review

IP international journal of forensic medicine and toxicological sciences, 2020

Over the last few years there is a rise in use of button batteries in various toys and other electronic gadgets. Easy availability and small size of these batteries pose a significant risk of ingestion in small children. Button battery ingestion can lead to serious health hazards very rapidly. A 2-year-old girl presented to the emergency room of a community hospital complaining of hematemesis. X-ray showed a coin lithium battery located in the esophagus, and she was transferred to a referral hospital and succumbed to death after 4 hours survival in king george hospital. Postmortem examination revealed massive blood clots in stomach.

Aspiration pneumonia and esophagotracheal fistula secondary to button battery ingestion

Forensic Science, Medicine, and Pathology, 2011

We report a case of acute bronchopneumonia and esophagotracheal fistula caused by a swallowed button battery in a 3-year-old girl. It was unclear exactly how long the battery had been trapped in the esophagus. The patient had undergone a tonsillectomy and adenoidectomy 3 weeks before the battery was finally exposed on an X-ray film. She refused to eat solid food after the surgery and stopped eating completely 10 days later. Three weeks after surgery, she presented to the Emergency Department with vomiting and acute respiratory distress, experienced cardiopulmonary arrest in the intensive care unit and could not be resuscitated. Postmortem examination revealed severe acute bronchopneumonia and massive blood aspiration due to an esophagotracheal fistula secondary to a button battery lodged in the esophagus. This case highlights the importance of including a swallowed button battery in the differential diagnosis of a toddler with dysphagia and anorexia.