Pediatric cylindrical battery ingestion

TL;DR

This study examines how children who accidentally swallow cylindrical batteries present clinically and what outcomes they experience, finding that most cases can be managed conservatively.

Contribution

The study provides new clinical data on pediatric cylindrical battery ingestion, offering guidance on when conservative management is appropriate versus when intervention is needed.

Findings

Most children who ingested cylindrical batteries did not experience severe complications.

Endoscopic removal was safe and did not cause mucosal lesions or perforation.

Conservative management is advised for most cases unless specific risk factors are present.

Abstract

Accidental ingestion of batteries is well documented in pediatric medical literature, but very few data exist in pediatric medical literature about ingestions of cylindrical batteries (CBs). The aim of our study was to evaluate the features, clinical presentation and clinical outcome of children who have ingested CBs.

All children admitted for CB ingestion were retrospectively recruited. Clinical data until hospital discharge were accurately recorded, including child age and sex, ingestion modality, signs and symptoms following ingestion, type of CB, results of neck-chest-abdominal x-ray performed to assess the retention site of CB, outcome of endoscopic removal, and whether performed.

Forty-five children (males/females: 26/19; age range: 7–168 months; mean age ± standard deviation: 42 ± 33.9 months) were enrolled. Of them, 15 of 45 (33.3%) had ingested AA batteries whereas 30 of 45 (66.6%) had ingested AAA batteries. CBs were retained in the esophagus in two of 45 children (4.4%), in the stomach in 19 of 45 children (42.2%), and in the duodenum or beyond in the remaining 24 of 45 children (53.3%). None of the patients who underwent endoscopic removal (12/45) had any esophageal or gastric mucosal lesions. No cases of intestinal perforation or surgical complications were reported.

According to our study data, conservative management may be advised for the majority of cases of CB ingestion. However, we acknowledge that CB should be timely removed whenever they are A23 or A27 type, damaged prior to ingestion, in cases of multiple ingestion, whenever retained in the stomach for a prolonged period, or whenever a child complains about any clinical signs or symptoms or had undergone prior abdominal surgery.

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