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)
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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.


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.


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.


1805180920_battery_algorithm.docx (123 Kb)