Button cell battery as foreign body ingestion in children: A retrospective analysis in a tertiary care center
Abstract
Button cell foreign bodies are increasingly presented as foreign bodies in esophagus. Many a time no positive id on button cell and can be mistaken as foreign body coin and delayed for management. Retrospectively analyze of 19 admitted cases with foreign body ingestion in children for foreign body Lithium ion battery button cell in esophagus done with the aim to evaluate epidemiology, clinical presentation and duration of presentation, radiological findings, endoscopic findings and complications in such cases. Clinical record of patients with foreign body Button cell batteries was reviewed and compiled in Microsoft Excel sheet and descriptive and percentage analysis was done. There were 11 (57.89%) male patients and 8 female patients. History of foreign body battery cell was given by the parents of 10 children. 3 patients presented with respiratory complains. After history and radiological examination in 17 out of 19 patients presence of lithium cell battery was suspected prior to endoscopic removal. In 4 patients severe mucosal injury noted. It was concluded from this study that foreign body button cell can cause serious injuries to upper aerodigestive tract. These should be promptly removed.
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Introduction
The natural curiosity of children leads them to ingest many types of non-edible objects. Mostly swallow foreign bodies are accidental but sometimes individuals ingest, coins, pencil tips, metallic foreign bodies, battery cells (lithium) and while meat bone (chicken bone/fish bone/mutton/buff) are common in adults and elderly.1-3 The majority of foreign objects ingestions occur in between six months and six years of age while in adults true foreign object ingestion commonly occurs among those with psychiatric disorders, mental retardation or impairment caused by alcohol and old age.2 Foreign bodies frequently lodge in the cricopharyngeal and oesophageal regions because off point of natural narrowing at 15 and 25 centimetres, but impaction at these level may have more to do with motility patterns than anatomy.1 -3 All blunt or sharp foreign bodies should be considered as an emergency to reduce the associated complications. If not removed on time, it can cause intramural mucosal injury, perforation, subacute mediastinitis, aortoesophageal fistula, tracheoesophageal fistula, and long-term residual injury to the esophagus.4
The lithium battery cells are increase morbidity as they causes early mucosal damage, and may lead to life-threatening complications in long-standing cases.3, 4 Swallowed coin-size lithium batteries become lodged in the upper esophagus and react quickly with saliva. The battery discharges a current that hydrolyzes water and generates hydroxide, creating a caustic injury to the tissue. Therefore, removal of these should be accorded highest priority to prevent complications. 3, 5, 6
Conclusion
This present study concludes that foreign body button cell battery cases are increasing but there is delay in reporting and referral of patient. General public should be informed for the hazards due to accidental ingestion of batteries and the prompt management required. Action is also required from the manufacturers of electronic devices to secure and fix these batteries properly.