Most foreign body ingestions in childhood are harmless. But every rule or statement has an exception, and in this case it is button batteries , the ingestion of which can be said to constitute a medical emergency that must be solved as quickly as possible because this type of battery carries a high rate of complications and including death.
In the United States, according to statistics from the National Poison Data System , between 2006 and 2017, 27,133 cases of ingestion of button batteries were described in patients under 6 years of age, an age range that constitutes more than half of the children who swallow batteries. .
In that same period of time, 24 children died and 144 presented serious complications for this reason. In that country alone, there were 3,467 ingestions of button batteries in the calendar year 2019.
It seems that cases and complications are increasing for several reasons:
- We have more and more electronic devices and, therefore, they are more likely to be within the reach of children.
- Each time they are manufactured with a larger diameter (more than 20 mm in diameter).
- They are becoming more powerful (more than 3 volts).
How does the substance of batteries affect the human body?
The mechanisms that cause injury depend on the type of battery. Specifically, button cell batteries are the most dangerous . This is due to the fact that button batteries lodge in the esophagus and quickly and progressively necrotize its wall and the tissue around the battery through four mechanisms:
- Caustic Injury – Battery corrodes and contents of alkaline batteries (not lithium ion) leak. This content penetrates into adjacent tissue and causes tissue death by a local chemical burn.
- Injury due to residual electrical current in the battery: around the negative pole of the battery, a kind of chemical reaction occurs with the production of alkaline substances that erode the mucous membranes.
- Mercury toxicity if the concentration is greater than 5 grams.
- Death of the tissue around the pile due to direct pressure from it.
Symptoms of swallowing a coin cell battery
It may be that we have not seen how the child swallows the button cell, but we can suspect it due to a series of symptoms. The problem is that they are not very specific and will have to be associated with the activity that the child was doing. We can always check it by looking if any object is missing any.
If you have been playing with an object with this type of battery and begin to experience pain, vomiting, coughing, excessive salivation and difficulty swallowing , it may be that the battery in the toy was swallowed.
What to do if a child eats a button battery?
Whether we suspect that a child has swallowed a button battery, or if we have seen it, what we have to do is go to an emergency room to have an X-ray done .
It is important not to give anything to eat or drink or induce vomiting or administer laxatives. And if we have seen it and we can take another battery from the device (or some reference), we take it to the emergency room in case it was of any use.
And yes, you have to go to the emergency room . We have two hours to act or remove it before they begin to cause damage . But it all depends on several factors. According to Pérez-Martínez, in a case published in the journal Annals of the Navarra Health System, “the potentially most serious situation that worsens the patient’s prognosis is when the rule of three doses is fulfilled”:
- Child under two years old (small esophagus).
- Battery greater than two centimeters in diameter (large button cell).
- Time: intake more than two hours ago
The chest or abdominal X-ray that will be performed on the patient is a quick and painless test. And it is the key to determine the subsequent action. Depending on the size of the battery, the time, its location and whether or not the patient has symptoms, one action or another will be carried out .
In the case where it is in the esophagus, an emergency endoscopy will be performed to remove it and evaluate the damage to the esophagus. If you have acted quickly, it is possible that everything has been left in a scare.
What happens if a child eats a button battery?
It is important to remember that the seriousness of the situation and the speed with which we have to act only applies to button cell batteries . The handling and injuries caused by other types of batteries are different. For this reason, the European Society of Pediatric Gastroenterology, Hepatology and Nutrition has prepared the first European position paper with a clinical guideline that determines what to do regarding the management, diagnosis and treatment of button battery ingestions.
In this document they collect the complications that can occur if a child eats a button battery and the list is long as well as terrifying. To give some examples, at the digestive level, perforation of the esophagus, trachea, stomach and small intestine can occur .
What happens if a child puts a battery up his nose?
Whether a child sticks a button battery up their nose or ears, we keep up the old show. We must go to the emergency room to have it removed because the substance of the batteries causes damage.
Perforation of the nasal septum, tympanic membrane, facial nerve paralysis and other very serious pathologies that can cause death or significant sequelae in our little ones can occur.
With button cell batteries ‘better safe than sorry’
As they say, prevention is better than cure. To do this, the Spanish Association of Pediatrics recommends:
- Keep button batteries and the objects that contain them (remote controls, thermometers, key rings, scales, calculators, watches, etc.) out of the reach of children.
- Check that the battery cover is properly closed and, if it is damaged or broken, make sure that it is properly closed (for example, with a strong adhesive tape).
- Do not leave any button cell batteries, including used and recyclable ones, loose on any surface.
References:
AEPED. Child Injury Prevention and Safety Committee. The danger of ingesting button batteries. Spanish Association of Pediatrics. Available at: https://www.aeped.es/comite-seguridad-y-prevencion-lesiones-infantiles/documentos/peligro-ingest
Medina et al. 2018. Experience in the management of battery ingestion in a pediatric hospital. Pediatric surgery. Available at: https://www.secipe.org/coldata/upload/revista/2018_31-3_121-124.pdf
Mubarak. 2021. Diagnosis, Management, and Prevention of Button Battery Ingestion in Childhood: A European Society for Paediatric Gastroenterology Hepatology and Nutrition Position Paper. Journal of Pediatric Gastroenterology and Nutrition. DOI: 10.1097/MPG.0000000000003048
Patoulias et al. 2016. Multiple gastric erosion early after a 3 V lithium battery (CR2025) ingestion in an 18-month-old male patient: Consideration about the proper time of intervention. Case Reports in Pediatrics. DOI: https://doi.org/10.1155/2016/3965393
Perez et al. 2021. Button batteries impacted in the esophagus: a life-threatening surgical emergency in childhood. Annals Health System Annals. DOI: https://dx.doi.org/10.23938/assn.0874 .
