Evaluation of a Symptom-Based Algorithm for Managing Battery Ingestions in Children.
Objectives: While complications from battery ingestion can be severe, especially with the emergence of stronger battery elements, not all ingestions require prompt removal. We aim to evaluate a symptom-focused algorithm for battery ingestion that emphasizes observation over intervention to investigate its safety.
Materials and methods: Patients were identified through a query of foreign-body ingestion radiographs obtained between 2017 and 2020. A retrospective chart review was then performed of all patients who presented with button battery ingestions to identify compliance with our algorithm, overall outcomes, and complications.
Results: In total, 2% of all radiographs (44/2,237) demonstrated button battery ingestions. The median age of patients was 3.8 years (interquartile range, 2.6-5.3). Most batteries were found in the stomach (64%, n = 28), but were also identified in the esophagus (14%, n = 6), small bowel (14%, n = 6), and colon (9%, n = 4). All esophageal batteries were managed with immediate endoscopic retrieval. Ten gastric batteries were not managed per protocol, with seven admitted for observation despite being asymptomatic and repeat abdominal X-rays demonstrating persistent gastric location of the battery. Four patients underwent esophagogastroduodenoscopy; however, in two patients the battery had migrated past the stomach prior to intervention. All small bowel batteries and three of four asymptomatic colon batteries were managed per protocol; one patient had additional imaging that demonstrated battery passage.
Conclusion: Adherence to a symptom-focused protocol for conservative management of button battery ingestions beyond the gastroesophageal junction is safe and frequently does not require admission, serial imaging, or intervention.
European journal of pediatric surgery : official journal of Austrian Association of Pediatric Surgery ... [et al] = Zeitschrift fur Kinderchirurgie
Algorithms; Child; Child, Preschool; Eating; Electric Power Supplies; Foreign Bodies; Humans; Retrospective Studies
Algorithms; Eating; Electric Power Supplies; Foreign Bodies; Retrospective Studies
Fraser JA, Briggs KB, Svetanoff WJ, Attard TM, Oyetunji TA, St Peter SD. Evaluation of a Symptom-Based Algorithm for Managing Battery Ingestions in Children. Eur J Pediatr Surg. 2022;32(1):2-8. doi:10.1055/s-0041-1740537