Clinical analysis of disc battery ingestion in children

Background: The purpose of this study was to evaluate the characteristics, management, and outcomes of disc battery ingestion in children. Methods: We reviewed the medical records of children aged between 1 and 15 years old admitted to Chang Gung Children's Hospital due to disc battery ingestion from September 1997 through July 2003). The diagnosis of disc battery ingestion was based upon history, clinical symptoms, and results of imaging studies. The clinical data reviewed included sex, age, clinical manifestation, hospital course, imaging findings, and endoscopic results. Results: We found 12 cases (8 males and 4 females) of disc battery ingestion with a mean age of 1.8 ± 3.43 years (range, 9 months to 5 years). Two patients had symptoms of vomiting, nausea, and abdominal pain. Two cases with no history of disc battery ingestion and were accidentally found by X ray studies. Four cases had their batteries impacted in the esophagus and eight cases had their batteries impacted in stomach. In those patients with esophageal impaction, one died suddenly, and the batteries were removed successfully by endoscope in the other three. Among those patients with batteries in the stomach, two patients underwent endoscope removal and the other 6 patients experienced smooth courses and the batteries spontaneously passed through the gastrointestinal tract within 5 days. The diameter of the ingested disc batteries ranged from 12 mm to 23 mm. The duration of hospitalization varied from 1 day to 61 days. Four patients had obvious damage of gastrointestinal mucosa including three esophageal mucosal erosion lesions, and one gastric mucosa erosion lesions with hemorrhage. Two patients experienced complications: one died suddenly due to tension in the pneumothorax and penumoperitoneum and the other had tracheoesophageal fistula. Conclusions: Most cases of disc battery ingestion run uneventful courses. However, the ingestion of some disc batteries may be fatal or complicated with life-threatening events. If the battery impacts in the esophagus, emergency endoscopic management is necessary. Once in the stomach, the battery will usually pass through the gastrointestinal tract without long-term complications.