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Review
. 2016 Jan;26(1):99-118.
doi: 10.1016/j.giec.2015.08.003.

Button Battery Ingestion in Children: A Paradigm for Management of Severe Pediatric Foreign Body Ingestions

Kristina Leinwand  1 , David E Brumbaugh  1 , Robert E Kramer  2
Affiliations
Review

Button Battery Ingestion in Children: A Paradigm for Management of Severe Pediatric Foreign Body Ingestions

Kristina Leinwand et al. Gastrointest Endosc Clin N Am. 2016 Jan.

Abstract

Gastrointestinal injuries secondary to button battery ingestions in children have emerged as a dangerous and difficult management problem for pediatricians. Implementation of a multidisciplinary team approach, with rapid and coordinated care, is paramount to minimize the risk of negative outcomes. In addition to providing a comprehensive review of the topic, this article outlines the authors' referral center's experience with patients with severe battery ingestion, highlighting the complications, outcomes, and important lessons learned from their care. The authors also propose an algorithm for clinical care that may be useful for guiding best management of pediatric button battery ingestion.

Keywords: Aortoesophageal fistula; Button battery ingestion; Caustic ingestion; Esophageal stricture; Foreign body ingestion; Gastrointestinal hemorrhage; MRI; Pediatric.

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Figures

Fig. 1
Fig. 1
Severe esophageal injury at site of BB removal, with necrosis and eschar.
Fig. 2
Fig. 2
Sites of esophageal button battery impaction and related risk of injury.
Fig. 3
Fig. 3
T1 MRI with contrast 5 days after BB removal showing persistent inflammation anterior to esophagus (black arrow) above aortic arch (white arrow).
Fig. 4
Fig. 4
Suggested algorithm for management of BBIs in children. Anbx, antibiotics; UGI, upper gastrointestinal. (Adapted from Kramer RE, Lerner DG, Lin T, et al. Management of ingested foreign bodies in children: a clinical report of the NASPGHAN Endoscopy Committee. J Pediatr Gastroenterol Nutr 2015;60(4):564; with permission.)
See this image and copyright information in PMC

References

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