UMEM Educational Pearls

Category: Pediatrics

Title: Development of an algorithm for battery ingestion

Keywords: Button batteries, removal (PubMed Search)

Posted: 5/18/2018 by Jenny Guyther, MD (Updated: 3/5/2024)
Click here to contact Jenny Guyther, MD

Question

There were 180 battery ingestions over a 5 year period at two tertiary care children’s hospital.  The median age was 3.8 years (0.7 to 18 years).  The most common symptoms were abdominal pain (17%), and nausea and vomiting (14%).  X-rays detected the location in 94% of patients.

Based on these patients, a treatment algorithm was developed (See attached).  Prospective validation is needed.

Answer

All patients with esophageal batteries had an intervention (foley catheter removal with post procedure esophagram, ridged esophagram or EGD).

The majority of patients with a gastric battery or small bowel battery were managed non operatively.

20 patients had a colonic battery and 7 had symptoms of abdominal pain or nausea or vomiting.

For batteries distal to the gastroesophageal junction, 16 patients had an intervention.  13 had an EGD with a 69% retrieval rate.  1 patient had a colonoscopy with successful retrieval.  2 patients had abdominal surgery with retrieval.

References

Rosenfled et al.  Battery ingestions in children: Variations in care and development of a clinical algorithm.  Journal of Pediatric Surgery.  2018.  Epub ahead of print.


Attachments

1805180920_battery_algorithm.docx (123 Kb)