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Foreign Body Ingestion in Children: Should Button Batteries in the Stomach Be Urgently Removed?

Lee JH, Lee JH, Shim JO, Lee JH, Eun BL, Yoo KH - Pediatr Gastroenterol Hepatol Nutr (2016)

Bottom Line: We investigated patient age, shape, size, location of FBs, spontaneous passage time and resulting complications among 76 children.Their shapes and sizes were not associated with the spontaneous passage time.Size, spontaneous passage time, and age were also not associated with any specific complications.

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatrics, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea.

ABSTRACT

Purpose: Foreign body (FB) ingestion is common in children, and button battery (BB) ingestion has been increasing in recent years. This study was to identify factors related to outcomes of FB ingestion, particularly BBs in the stomach. We evaluated whether the current recommendations are appropriate and aimed to suggest indications for endoscopic removal of BB in the stomach in young children.

Methods: We investigated patient age, shape, size, location of FBs, spontaneous passage time and resulting complications among 76 children. We observed types, size, location of BB and outcomes, and analyzed their associations with complications.

Results: Coins and BB were the two most common FBs. Their shapes and sizes were not associated with the spontaneous passage time. Size, spontaneous passage time, and age were also not associated with any specific complications. For BB ingestion, all 5 cases with lithium batteries (≥1.5 cm, 3 V) presented moderate to major complications in the esophagus and stomach without any symptoms, even when the batteries were in the stomach and beyond the duodenum, while no complications were noted in 7 cases with alkaline batteries (<1.5 cm, 1.5 V) (p=0.001). All endoscopies were conducted within 24 hours after ingestion.

Conclusion: The type and voltage of the battery should be considered when determining whether endoscopy is required to remove a BB in the stomach. For lithium battery ingestion in young children, urgent endoscopic removal might be important in order to prevent complications, even if the child is asymptomatic and the battery is smaller than 2 cm.

No MeSH data available.


Related in: MedlinePlus

Flow diagram of patient selection.
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Figure 1: Flow diagram of patient selection.

Mentions: In children who ingested a button battery, we also investigated the types, models, currents, and voltages of the batteries. Endoscopic findings were analyzed with relations to these factors to determine which are associated to complications (Fig. 1). Medical outcomes, including endoscopic findings, were defined modifying those of National Poison Data System of America as follow: (1) no complications: no signs or symptoms, (2) minor complication: minimal signs or symptoms that resolved rapidly, (3) moderate complication: more pronounced, prolonged, or multiple signs or symptoms, such as bloody stool or emesis, erosions, shallow ulcers or mucosal burns without sequelae, (4) major complication: significant residual disability, such as deep ulcers or mucosal burns with protracted healing or long-term sequelae, systemic effects, perforation, or fistula [10].


Foreign Body Ingestion in Children: Should Button Batteries in the Stomach Be Urgently Removed?

Lee JH, Lee JH, Shim JO, Lee JH, Eun BL, Yoo KH - Pediatr Gastroenterol Hepatol Nutr (2016)

Flow diagram of patient selection.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4821979&req=5

Figure 1: Flow diagram of patient selection.
Mentions: In children who ingested a button battery, we also investigated the types, models, currents, and voltages of the batteries. Endoscopic findings were analyzed with relations to these factors to determine which are associated to complications (Fig. 1). Medical outcomes, including endoscopic findings, were defined modifying those of National Poison Data System of America as follow: (1) no complications: no signs or symptoms, (2) minor complication: minimal signs or symptoms that resolved rapidly, (3) moderate complication: more pronounced, prolonged, or multiple signs or symptoms, such as bloody stool or emesis, erosions, shallow ulcers or mucosal burns without sequelae, (4) major complication: significant residual disability, such as deep ulcers or mucosal burns with protracted healing or long-term sequelae, systemic effects, perforation, or fistula [10].

Bottom Line: We investigated patient age, shape, size, location of FBs, spontaneous passage time and resulting complications among 76 children.Their shapes and sizes were not associated with the spontaneous passage time.Size, spontaneous passage time, and age were also not associated with any specific complications.

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatrics, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea.

ABSTRACT

Purpose: Foreign body (FB) ingestion is common in children, and button battery (BB) ingestion has been increasing in recent years. This study was to identify factors related to outcomes of FB ingestion, particularly BBs in the stomach. We evaluated whether the current recommendations are appropriate and aimed to suggest indications for endoscopic removal of BB in the stomach in young children.

Methods: We investigated patient age, shape, size, location of FBs, spontaneous passage time and resulting complications among 76 children. We observed types, size, location of BB and outcomes, and analyzed their associations with complications.

Results: Coins and BB were the two most common FBs. Their shapes and sizes were not associated with the spontaneous passage time. Size, spontaneous passage time, and age were also not associated with any specific complications. For BB ingestion, all 5 cases with lithium batteries (≥1.5 cm, 3 V) presented moderate to major complications in the esophagus and stomach without any symptoms, even when the batteries were in the stomach and beyond the duodenum, while no complications were noted in 7 cases with alkaline batteries (<1.5 cm, 1.5 V) (p=0.001). All endoscopies were conducted within 24 hours after ingestion.

Conclusion: The type and voltage of the battery should be considered when determining whether endoscopy is required to remove a BB in the stomach. For lithium battery ingestion in young children, urgent endoscopic removal might be important in order to prevent complications, even if the child is asymptomatic and the battery is smaller than 2 cm.

No MeSH data available.


Related in: MedlinePlus