Esophageal lesions following button-battery ingestion in children: Analysis of causes and proposals for preventive measures

Objectives: To study recent cases of esophageal injury due to button-battery ingestion in children presenting in pediatric ENT emergency departments of the Paris area of France (Ile-de-France region), inorder to propose appropriate preventive measures. Material and method: A retrospective descriptive single-center study included all children under 15 years of age, presenting in pediatric ENT emergency departments between January 2008 and April 2014 for button-battery ingestion with esophageal impaction requiring emergency removal. Results: Twenty-two boys and 4 girls, with a median age of 25 months, were included. Twenty-five of the 26 batteries had diameters of 20 mm or more. Median esophageal impaction time was 7 hours 30 minutes (range, 2 to 72 hours). The complications rate was 23%. Mean hospital stay cost was (sic) 38,751( range, (sic) 5130-119,737). The origin of the battery was known in 23 of the 26 cases: remote control without screw-secured compartment (42.3%), open battery pack (15.4%), children's toy (15.3%), camera( 7.7%), watch (1 case) and hearing aid without screw-secured compartment (1 case). Conclusion: Esophageal lesions due to ingestion of button-batteries in children are almost always due to batteries larger than 20 mm in diameter, mostly from devices with a poorly protected compartment, or batteries that are not individually packaged. These lesions cause serious complications in a quarter of cases and their management entails high health costs. Legislation requiring screw-secured compartments and individual blisters for batteries could have prevented 69.2% of the ingestions. (c) 2017 Elsevier Masson SAS. All rights reserved.