Button and cylindrical battery ingestion: Clinical features, diagnosis, and initial management
- Kelly Sinclair, MD
Kelly Sinclair, MD
- Associate Professor of Pediatrics
- The Children's Mercy Hospital
- Ivor D Hill, MD
Ivor D Hill, MD
- Professor of Pediatrics
- Section Chief, Pediatric Gastroenterology and Nutrition
- Nationwide Children's Hospital
- Section Editors
- Michele M Burns, MD, MPH
Michele M Burns, MD, MPH
- Section Editor — Pediatric Toxicology
- Assistant Professor of Pediatrics and Emergency Medicine
- Harvard Medical School
- Melvin B Heyman, MD, MPH
Melvin B Heyman, MD, MPH
- Section Editor — Gastroenterology
- Professor of Pediatrics
- University of California, San Francisco
- Deputy Editor
- James F Wiley, II, MD, MPH
James F Wiley, II, MD, MPH
- Senior Deputy Editor — UpToDate
- Deputy Editor — Adult and Pediatric Emergency Medicine
- Deputy Editor — Primary Care Sports Medicine (Adolescents and Adults)
- Clinical Professor of Pediatrics and Emergency Medicine/Traumatology
- University of Connecticut School of Medicine
The evaluation and management of button and cylindrical battery ingestion will be presented here.
The management of button batteries in the ear or nose, esophageal foreign bodies other than button batteries, and corrosive esophageal injury are discussed separately as follows:
- Litovitz T, Schmitz BF. Ingestion of cylindrical and button batteries: an analysis of 2382 cases. Pediatrics 1992; 89:747.
- Litovitz T, Whitaker N, Clark L, et al. Emerging battery-ingestion hazard: clinical implications. Pediatrics 2010; 125:1168.
- Litovitz TL. Button battery ingestions. A review of 56 cases. JAMA 1983; 249:2495.
- Thompson N, Lowe-Ponsford F, Mant TG, Volans GN. Button battery ingestion: a review. Adverse Drug React Acute Poisoning Rev 1990; 9:157.
- Litovitz TL. Battery ingestions: product accessibility and clinical course. Pediatrics 1985; 75:469.
- Mofenson HC, Greensher J, Caraccio TR, Danoff R. Ingestion of small flat disc batteries. Ann Emerg Med 1983; 12:88.
- Sharpe SJ, Rochette LM, Smith GA. Pediatric battery-related emergency department visits in the United States, 1990-2009. Pediatrics 2012; 129:1111.
- Centers for Disease Control and Prevention (CDC). Injuries from batteries among children aged <13 years--United States, 1995-2010. MMWR Morb Mortal Wkly Rep 2012; 61:661.
- Litovitz T, Whitaker N, Clark L. Preventing battery ingestions: an analysis of 8648 cases. Pediatrics 2010; 125:1178.
- Millar AJ, Rode H, Cywes S, Van Der Walt F. Button-battery ingestion--a hazard of modern living. S Afr Med J 1985; 68:868.
- Levine MJ, Jacob H, Rubin M. Battery ingestion: a potential form of alkaline injury to the gastrointestinal tract. Ann Emerg Med 1984; 13:143.
- 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; 60:562.
- International electrotechnical Commission. www.iec.ch/ (Accessed on June 02, 2010).
- Sigalet D, Lees G. Tracheoesophageal injury secondary to disc battery ingestion. J Pediatr Surg 1988; 23:996.
- Rumack BH, Rumack CM. Disk battery ingestion. JAMA 1983; 249:2509.
- Temple DM, McNeese MC. Hazards of battery ingestion. Pediatrics 1983; 71:100.
- Bass DH, Millar AJ. Mercury absorption following button battery ingestion. J Pediatr Surg 1992; 27:1541.
- Maves MD, Carithers JS, Birck HG. Esophageal burns secondary to disc battery ingestion. Ann Otol Rhinol Laryngol 1984; 93:364.
- Langkau JF, Noesges RA. Esophageal burns from battery ingestion. Am J Emerg Med 1985; 3:265.
- Yamashlta M, Saito S, Koyama K, et al. Esophageal electrochemical burn by button-type alkaline batteries in dogs. Vet Hum Toxicol 1987; 29:226.
- Rebhandl W, Steffan I, Schramel P, et al. Release of toxic metals from button batteries retained in the stomach: An in vitro study. J Pediatr Surg 2002; 37:87.
- Litovitz T, Butterfield AB, Holloway RR, Marion LI. Button battery ingestion: assessment of therapeutic modalities and battery discharge state. J Pediatr 1984; 105:868.
- Kost KM, Shapiro RS. Button battery ingestion: a case report and review of the literature. J Otolaryngol 1987; 16:252.
- Mallon PT, White JS, Thompson RL. Systemic absorption of lithium following ingestion of a lithium button battery. Hum Exp Toxicol 2004; 23:193.
- Kuhns DW, Dire DJ. Button battery ingestions. Ann Emerg Med 1989; 18:293.
- Kulig K, Rumack CM, Rumack BH, Duffy JP. Disk battery ingestion. Elevated urine mercury levels and enema removal of battery fragments. JAMA 1983; 249:2502.
- Mant TG, Lewis JL, Mattoo TK, et al. Mercury poisoning after disc-battery ingestion. Hum Toxicol 1987; 6:179.
- Reilly DT. Mercury battery ingestion. Br Med J 1979; 1:859.
- D'Sa Barros EA, D'Sa Barros AA. Mercury battery ingestion. Br Med J 1979; 1:1218.
- Barber TE, Menke RD. The relationship of ingested iron to the absorption of mercuric oxide. Am J Emerg Med 1984; 2:500.
- Samad L, Ali M, Ramzi H. Button battery ingestion: hazards of esophageal impaction. J Pediatr Surg 1999; 34:1527.
- David TJ, Ferguson AP. Management of children who have swallowed button batteries. Arch Dis Child 1986; 61:321.
- Shastri N, Leys C, Fowler M, Conners GP. Pediatric button battery and small magnet coingestion: two cases with different outcomes. Pediatr Emerg Care 2011; 27:642.
- Fuentes S, Cano I, Benavent MI, Gómez A. Severe esophageal injuries caused by accidental button battery ingestion in children. J Emerg Trauma Shock 2014; 7:316.
- Peters NJ, Mahajan JK, Bawa M, et al. Esophageal perforations due to foreign body impaction in children. J Pediatr Surg 2015; 50:1260.
- Cruz CI, Patel D. Impacted button-battery masquerading as croup. J Emerg Med 2013; 45:30.
- "NBIH Button battery ingestion triage and treatment guideline". National Captial Poison Center. www.poison.org/battery/guideline.asp (Accessed on February 28, 2017).
- Maves MD, Lloyd TV, Carithers JS. Radiographic identification of ingested disc batteries. Pediatr Radiol 1986; 16:154.
- Bernstein JM, Burrows SA, Saunders MW. Lodged oesophageal button battery masquerading as a coin: an unusual cause of bilateral vocal cord paralysis. Emerg Med J 2007; 24:e15.
- Webb WA. Management of foreign bodies of the upper gastrointestinal tract: update. Gastrointest Endosc 1995; 41:39.
- Brumbaugh DE, Colson SB, Sandoval JA, et al. Management of button battery-induced hemorrhage in children. J Pediatr Gastroenterol Nutr 2011; 52:585.
- Gordon AC, Gough MH. Oesophageal perforation after button battery ingestion. Ann R Coll Surg Engl 1993; 75:362.
- Kimball SJ, Park AH, Rollins MD 2nd, et al. A review of esophageal disc battery ingestions and a protocol for management. Arch Otolaryngol Head Neck Surg 2010; 136:866.
- Soccorso G, Grossman O, Martinelli M, et al. 20 mm lithium button battery causing an oesophageal perforation in a toddler: lessons in diagnosis and treatment. Arch Dis Child 2012; 97:746.
- McDermott VG, Taylor T, Wyatt JP, et al. Orogastric magnet removal of ingested disc batteries. J Pediatr Surg 1995; 30:29.
- Jaffe RB, Corneli HM. Fluoroscopic removal of ingested alkaline batteries. Radiology 1984; 150:585.
- Ito Y, Ihara N, Sohma S. Magnetic removal of alkaline batteries from the stomach. J Pediatr Surg 1985; 20:250.
- Rivera EA, Maves MD. Effects of neutralizing agents on esophageal burns caused by disc batteries. Ann Otol Rhinol Laryngol 1987; 96:362.
- Aronow, R. Mercury. In: Clinical Management of poisoning and Drug Overdose, 2nd, Haddad, LM (Eds), WB Saunders, Philadelphia 1990. p.1004.
- Namasivayam S. Button battery ingestion: a solution to a management dilemma. Pediatr Surg Int 1999; 15:383.
- Wall SJ, Nadel DM, Handler SD. Airway compromise caused by disk battery ingestion. Otolaryngol Head Neck Surg 1999; 121:302.
- Anand TS, Kumar S, Wadhwa V, Dhawan R. Rare case of spontaneous closure of tracheo-esophageal fistula secondary to disc battery ingestion. Int J Pediatr Otorhinolaryngol 2002; 63:57.
- Chiang MC, Chen YS. Tracheoesophageal fistula secondary to disc battery ingestion. Am J Otolaryngol 2000; 21:333.
- Willis GA, Ho WC. Perforation of Meckel's diverticulum by an alkaline hearing aid battery. Can Med Assoc J 1982; 126:497.
- Alkan M, Büyükyavuz I, Doğru D, et al. Tracheoesophageal fistula due to disc-battery ingestion. Eur J Pediatr Surg 2004; 14:274.
- Jatana KR, Litovitz T, Reilly JS, et al. Pediatric button battery injuries: 2013 task force update. Int J Pediatr Otorhinolaryngol 2013; 77:1392.
- Untersweg U, Mayr J, Schmidt B. Oesophageal burn caused by sucking a 1.5 volt battery. Acta Paediatr 1996; 85:1382.
- BUTTON BATTERY INGESTION
- Battery description
- Battery identification
- Clinical features
- - History
- - Signs and symptoms
- - Approach
- Radiographic localization
- Esophageal impaction
- Gastric location
- Intestinal location
- - Mercury toxicity
- CYLINDRICAL BATTERY INGESTION
- INFORMATION FOR PATIENTS
- ADDITIONAL RESOURCES
- SUMMARY AND RECOMMENDATIONS