The anesthetic management of button battery ingestion in children

Abstract

Purpose: Injuries related to button battery ingestion are common in children. This review provides an outline of the epidemiology, pathophysiology, management, and anesthetic implications in children who have ingested a button battery.

Source: A literature search was conducted in the United States National Library of Medicine PubMed database using the terms "button battery ingestion" and "children' and "removal" and "surgery" and "anesthesia". Ninety-six articles published in English were found from 1983-2017, and 62 of these articles were incorporated into this review. Additionally, the Internet was searched with the terms "button battery ingestion and children" to identify further entities, organizations, and resources affiliated with button battery ingestion in children. These additional sources were studied and included in this review.

Principal findings: Button batteries are ubiquitous in homes and electronic devices. Since 2006, larger-diameter and higher-voltage batteries have become available. These are more likely to become impacted in the esophagus after ingestion and lead to an increase in severe morbidity and mortality due to caustic tissue injury. Children at the highest risk for complications are those under six years of age who have ingested batteries > 20 mm in diameter and sustain prolonged esophageal impaction at the level of the aortic arch with the negative pole oriented anteriorly.

Conclusion: Anesthesiologists need to know about the epidemiology, pathophysiology, complications, and anesthetic management of children who have ingested button batteries.