Button battery ingestion: an analysis of 25 cases.

BACKGROUND: Button batteries represent a distinct type of foreign body. Serious complications can be resulted, particularly when the battery is impacted in the esophagus. The potentially detrimental effects of button battery ingestion have often been overlooked in Taiwan. We surveyed patients following button battery ingestion to define the characteristics and outcomes of this population.

METHODS: The records of 25 patients with button battery ingestion that had been reported to the Taipei Veterans General Hospital Poison Control Center from July 1988 through January 1998 were retrospectively reviewed.

RESULTS: Button battery ingestion occurred most commonly in male children (N=20; 80%) and children under 3 years of age (N= 19; 76%). Most children were asymptomatic (N=22; 88%). Two children suffered abdominal pain, and one suffered dyspnea and stridor. Reported complications included black stools (N=3) and tracheoesophageal fistula formation (N= 1). Two children underwent endoscopic battery removal, and batteries passed the entire gastrointestinal tract in all other subjects. The interval between battery ingestion and passage when documented (N= 16) was never more than 5 days.

CONCLUSION: Most ingested batteries passed through the gastrointestinal tract without any adverse effects. An initial roentgenogram should be obtained promptly to determine battery location and diameter, and the battery's chemical composition should be determined when possible. Esophageal impaction of the batteries requires emergency endoscopic or surgical removal. For patients without esophageal impaction, conservative intervention is recommended in the absence of symptoms and signs of injury.