Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Jul;177(7):1063-1070.
doi: 10.1007/s00431-018-3154-6. Epub 2018 May 2.

Serious complications after button battery ingestion in children

Hilde Krom  1 , Margot Visser  2 , Jessie M Hulst  3 , Victorien M Wolters  4 , Anita M Van den Neucker  5 , Tim de Meij  6 , Hubert P J van der Doef  7 , Obbe F Norbruis  8 , Marc A Benninga  9 , Margot J M Smit  10 , Angelika Kindermann  9
Affiliations

Serious complications after button battery ingestion in children

Hilde Krom et al. Eur J Pediatr. 2018 Jul.

Abstract

Serious and fatal complications after button battery ingestion are increasing worldwide. The aim of this study is to describe serious complications after battery ingestion in children in the Netherlands.All pediatric gastroenterologists in the Netherlands performing upper endoscopies were asked to report all serious complications after battery ingestion in children (0-18 years) between 2008 and 2016 retrospectively.Sixteen serious complications were reported: death after massive bleeding through esophageal-aortal fistula (n = 1), esophageal-tracheal fistula (n = 5), stenosis after (suspected) perforation and mediastinitis (n = 5), (suspected) perforation and mediastinitis (n = 3), vocal cord paralysis (n = 1), and required reintubation for dyspnea and stridor (n = 1). The median time interval between ingestion and presentation was 5 (IQR 2-258) h. All children were ≤ 5 (median 1.4; IQR 0.9-2.1) years. Vomiting (31.3%), swallowing/feeding problems (31.3%), and fever (31.3%) were the most common presenting symptoms; however, 18.8% of the patients were asymptomatic (n = 1 missing). All batteries were button batteries (75% ≥ 20 mm; 18.8% < 20 mm; n = 1 missing). The batteries were removed by esophagogastroduodenoscopy (50%) and rigid endoscopy (37.5%) or surgically (12.5%).

Conclusion: Sixteen serious complications occurred after small and large button batteries ingestion between 2008 and 2016 in both symptomatic and asymptomatic children in the Netherlands. Therefore, immediate intervention after (suspected) button battery ingestion is required. What is Known: • Button battery ingestion may result in serious and fatal complications. • Serious and fatal complications after button battery ingestion are increasing worldwide. What is New: • Sixteen serious complications after button battery ingestion occurred during 2008-2016 in children in the Netherlands. • Serious complications were also caused by small batteries (< 20 mm) in the Netherlands and also occurred in asymptomatic Dutch children.

Keywords: Button battery; Complications; Foreign body; Ingestion; Pediatrics.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest

The authors declare that they have no conflict of interest.

Informed consent

The Medical Research Involving Human Subjects Act does not apply to the study. Therefore, obtaining informed consent is not required.

References

    1. Brumbaugh DE, Colson SB, Sandoval JA, Karrer FM, Bealer JF, Litovitz T, et al. Management of button battery-induced hemorrhage in children. J Pediatr Gastroenterol Nutr. 2011;52(5):585–589. doi: 10.1097/MPG.0b013e3181f98916. - DOI - PubMed
    1. Buttazzoni E, Gregori D, Paoli B, Soriani N, Baldas S, Rodriguez H, et al. Symptoms associated with button batteries injuries in children: an epidemiological review. Int J Pediatr Otorhinolaryngol. 2015;79(12):2200–2207. doi: 10.1016/j.ijporl.2015.10.003. - DOI - PubMed
    1. Eliason MJ, Melzer JM, Winters JR, Gallagher TQ. Identifying predictive factors for long-term complications following button battery impactions: a case series and literature review. Int J Pediatr Otorhinolaryngol. 2016;87:198–202. doi: 10.1016/j.ijporl.2016.06.016. - DOI - PubMed
    1. van der Feen C, Kindermann A (2012) Ingestie van vreemde voorwerpen. Prakt Pediatr 2:70-73
    1. Gohil R, Culshaw J, Jackson P, Singh S. Accidental button battery ingestion presenting as croup. J Laryngol Otol. 2014;128(3):292–295. doi: 10.1017/S0022215114000073. - DOI - PubMed

LinkOut - more resources