A Very Dangerous Situation: Disk Battery Ingestion in Children

Keep Your Children Away From Small Flat Batteries!

Disk Battery Ingestion, Disk Battery Ingestion, Injuries from Batteries Among Children, Disc Battery Ingestion Poses Hazards to Kids,Coin Button Cell Batteries
Foreign body ingestion can be seen frequently in children. It should be emphasized that especially flat lithium batteries can damage the esophagus within hours and be much more dangerous than other coins or metal foreign objects.
In different countries, even campaigns have been launched to fix flat batteries and keep them away from small children.

In recent years, it has been aimed to reduce the size of the electronic toys gradually and to increase the battery capacity and to decrease the battery size in accordance with this. Small batteries can continue on their way in the digestive system without causing damage to other areas, especially if they pass through the esophagus. However, flat batteries inserted into the esophagus can cause serious tissue damage in a short time, such as a few hours, due to alkaline costal leaks. It can cause a full-thickness esophagus perforation in 4 hours.

Causes of Disk Battery Ingestion in Children

Battery ingestion is mostly seen in children under 5 years old and the elderly. It is most common in children aged 1-3 years.

In the elderly, it is most often swallowed during the replacement of hearing aid batteries or accidentally likened to pill-shaped drugs. In children, it is mostly swallowed for game or research purposes. In very rare cases, battery ingestion for suicidal purposes may occur.

With the increase in the use of small electronic devices in the last 20 years, the number of cases of flat battery ingestion, especially with a diameter of 20-25 mm, has increased approximately 20 times.

Battery Ingestion Symptoms

There may be no symptoms in the first few hours after the battery has been swallowed. Therefore, the patient's history and X-ray anteroposterior and lateral radiographs are of great importance in diagnosis.

The following symptoms may occur within a few hours of swallowing disc-shaped batteries:
  • Vomiting
  • Gagging
  • Abdominal pain
  • Low grade fever
  • Restlessness
  • Drooling
  • Difficulty breathing if the battery has blocked the airway
  • Allergic rash due to nickel metal
  • Dark and bloody stools
Some batteries may also contain mercury, so drowsiness, excitement, diaper rash or tremors may also be symptoms of mercury poisoning.

When Should I Go To The Hospital In Case Of Battery Ingestion?

Battery defeat is a medical emergency. Applying to the emergency department of the nearest hospital can provide early treatment before tissue damage begins.

How is Battery Ingestion Diagnosed?

double density (two-layer) shade on X-ray film
First of all, it is very important to take X-ray X-rays for the entire digestive system after the history and complaints information obtained from the patient. Disc batteries have a characteristic double density (two-layer) shade on X-ray films made with X-rays. In this way, they can be separated from other metal foreign objects such as coins, coins and buttons.

If it is determined that the flat battery is found in the esophagus (esophagus); the battery should be removed from that area immediately.

Photo source (for dual density (double layer) ghosting mark)  Button Battery in a Baby Boy | Consultant for Pediatricians - www.pediatricsconsultant360.com

Treatment of Battery Ingestion

When suspected of battery swallowing, it is important to go to the nearest hospital's emergency department without giving the patient any additional food or liquid orally. All disc-shaped batteries have an imprinted code used to describe the actual size and contents of the battery. If no other similar battery can be found, the device containing the battery can be examined. In the United States, "National Coin Cell Ingestion Hotline - The National Button Battery Ingestion Hotline" notifies this information of batteries for emergency calls. As far as I know, such an emergency line does not exist in our country yet.

Although antacids help to prevent leakage from disc batteries in animal models, the dose required for children can be too much. Drugs such as vomiting-inducing ipecac should not be used because batteries that pass safely into the stomach can cause them to leak back into the esophagus.

If the battery is 15.6 mm or larger, if the child is less than 6 years old, and the battery does not pass through the stomach within 48 hours, endoscopic removal of the battery may be planned.

If the battery contains mercury and is found to be fragmented; blood and urine mercury levels are required.

Precautions To Be Taken For Battery Ingestion in Children

Some precautions below are important to prevent battery ingestion. These:

Storage of batteries in child-proof containers
- Battery compartments in toys must be properly child-safe and taped with closed tapes.
- Creation of special battery boxes for elderly people, especially batteries in hearing aids
- Avoid holding the batteries in mouth when changing a battery.

Prognosis For Battery Ingestion

In the majority of cases of disc battery ingestion, conservative treatment and follow-up is sufficient. The battery is self-excreted from the digestive system. Serious health problems may arise especially in children under 4 years of age and in cases where large flat batteries (20-25 mm) are swallowed.

Flat pacemaking in the esophagus is usually seen in less than 1% of the cases.

Although heavy metal poisoning is theoretically possible, it has not been reported clinically.

You can watch the video below, "Button batteries pose 'deadly' risk to toddlers - BBC News", which describes the tissue damage caused by button batteries.

You can watch a video below that describes the tissue damage caused by disc batteries, showing how the battery inserted into the sausage causes damage:

Murat Enoz, MD, Otorhinolaryngology, Head and Neck Surgeon - ENT Doctor in Istanbul

Private Office:
Address: İncirli Cad. No:41, Kat:4 (Dilek Patisserie Building), Postal code: 34147, Bakırköy - İstanbul
Appointment Phone: +90 212 561 00 52
E-Mail: muratenoz@gmail.com 
Mobile phone: +90 533 6550199
Fax: +90 212 542 74 47