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Button Battery Ingestion
Everything in the library about button battery ingestion — built automatically from the recorded discussions that name it
Educational content from recorded physician discussions — not medical advice. Always talk to your child's care team about your child's situation.
Content of this collection
Surgical Management
1 item
QUAD #4: Surgical Management of Button Battery & Caustic Ingestion with Dr. Aaron Garrison
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Cincinnati Children's hosted the QUAD conference in October 2022 which was a combination of four conferences: The international organization for is Esophageal atresia, the Aerodigestive Society Conference, the Cincinnati Children's Airway c
video8:10 · Mar 2024
Evidence & Research
3 items
Pediatric button battery ingestion: A single center experience and risk score to predict severe outcomes
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Article you should know by Dr. Cecilia Gigena
"Pediatric button battery ingestion: A single center experience and risk score to predict severe outcomes" P. Nina Scalise, Jonathan M. Durgin, Steven J. Staffa, Nicole Wynne, Jay Meisner, P
video · May 2023
Ingestión de pila boton en pediatría: Experiencia de un centro y score de riesgo para predecir resultados
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Otro artículo que tenes que conocer por la dra Cecilia Gigena
“Ingestión de pila boton en pediatría: Experiencia de un centro y score de riesgo para predecir resultados” Scaline N et.al.
P. Nina Scalise, Jonathan M. Durgin, Steven J.
video · May 2023
Journal of pediatric surgery Article Review: April 2023, IPEG issue
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We’re featuring Journal of Pediatric surgery articles to bring you some of the latest news!
This week we are discussing three articles from the April 2023 issue, the IPEG issue with editor Dr. Mark Wulkan and authors Drs. Luzia Toselli,
podcast13:22 · Jul 2023
Case-Based Learning
1 item
Button Battery Ingestion
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At the 7th Annual Pediatric Surgery Update Course, Dr. Daniel von Allmen discusses management after button battery ingestion.
video14:28 · Mar 2020
Common questions
What do the experts recommend for Button Battery Ingestion?
For high-risk patients (age <5 years, larger battery size), endoscopic evaluation of the esophagus is recommended because the duration of battery presence higher up than the stomach is unknown. The Foley catheter technique may work for button battery removal when operating room access is delayed and symptom duration is short. Guidelines mandate serial MRIs for button battery cases due to concern for vascular injury. Risk stratification using specific criteria—battery location in the esophagus, battery size, and patient age—can identify severe outcomes and guide transfer decisions.
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Every expert statement below comes from the recorded discussions, with its speaker and moment.
QUAD #4: Surgical Management of Button Battery & Caustic Ingestion with Dr. Aaron Garrison
A 1992 study reviewed more than 2000 cases of button battery ingestion in children and found no deaths.
Host summaryEm Gootee summarizes what Dr. Aaron Garrison said — not the host's own clinical position0:41 ↗
Recent studies have found a sevenfold increase in fatalities following button battery ingestions.
Host summaryEm Gootee summarizes what Dr. Aaron Garrison said — not the host's own clinical position0:52 ↗
The increase in fatalities is because of the change to a 20-volt lithium cell which causes coagulative necrosis.
Host summaryEm Gootee summarizes what Dr. Aaron Garrison said — not the host's own clinical position0:59 ↗
There are 3 locations in the esophagus where button batteries tend to get stuck: the upper esophageal sphincter, behind the aortic arch, and at the lower esophageal sphincter.
clinicalAaron Garrison1:06 ↗
When a button battery sits in one of these positions, it causes transmural injury and will make a fistula between the esophagus and adjacent structures including trachea, blood vessels, or vocal cords.
Host summaryEm Gootee summarizes what Dr. Aaron Garrison said — not the host's own clinical position1:14 ↗
High-risk criteria include younger patients with smaller esophagus.
clinicalAaron Garrison1:33 ↗
A larger battery over 20 millimeters or greater is riskier.
Host summaryEm Gootee summarizes what Dr. Aaron Garrison said — not the host's own clinical position1:39 ↗
Longer duration that the battery has been in the esophagus is associated with worse outcomes.
clinicalAaron Garrison1:43 ↗
A battery behind the aortic arch is more concerning.
Host summaryEm Gootee summarizes what Dr. Aaron Garrison said — not the host's own clinical position1:49 ↗
If a patient has had a battery removed and presents later with a bleed, that is an emergency that needs to be taken seriously and requires a plan.
clinicalAaron Garrison1:52 ↗
In a Colorado study of 13 patients with high severity button battery injuries, 30% had esophageal perforation.
Host summaryEm Gootee summarizes what Dr. Aaron Garrison said — not the host's own clinical position2:05 ↗
In the Colorado study, 23% of patients developed stricture.
Host summaryEm Gootee summarizes what Dr. Aaron Garrison said — not the host's own clinical position2:14 ↗
Some patients in the Colorado study required G-tube placement and stayed in the hospital for nearly 2 weeks.
Host summaryEm Gootee summarizes what Dr. Aaron Garrison said — not the host's own clinical position2:16 ↗
Almost 25% of patients in the Colorado series died.
epidemiologicalAaron Garrison2:22 ↗
Two of the fatalities in the Colorado series presented with the button batteries already in the stomach.
epidemiologicalAaron Garrison2:22 ↗
Sentinel bleeds can be the first sign of aortoenteric fistulas.
Host summaryEm Gootee summarizes what Dr. Aaron Garrison said — not the host's own clinical position2:32 ↗
Any small communication between the esophagus and the aorta can be potentially life-threatening.
clinicalAaron Garrison2:41 ↗
Some aortoesophageal fistulas showed up over 2 weeks after the batteries were removed.
Host summaryEm Gootee summarizes what Dr. Aaron Garrison said — not the host's own clinical position2:50 ↗
Aortoesophageal fistulas do not always happen in the hospital, so having a high index of suspicion and a plan for what to do once the battery is removed is helpful.
clinicalAaron Garrison2:55 ↗
For sick patients with esophageal foreign bodies and active bleeding or clinical instability, it is recommended to have GI surgery and CT surgery available for the procedure.
guidelineAaron Garrison3:26 ↗
Imaging beforehand with a CTA to assess inflammation and proximity to the aorta is helpful.
Host summaryEm Gootee summarizes what Dr. Aaron Garrison said — not the host's own clinical position3:39 ↗
If imaging shows injury close to the aorta, continue NPO and antibiotics and repeat MRI in 5 to 7 days to assess the trajectory of inflammation.
guidelineAaron Garrison3:47 ↗
If there is any bleeding or concern for sentinel bleed, have a plan with interventional radiology, cardiology, or anyone who can help in that situation.
Host summaryEm Gootee summarizes what Dr. Aaron Garrison said — not the host's own clinical position3:59 ↗
In one case report with a pseudoaneurysm from the arch of the aorta, repair was done with a staged approach: sternotomy on bypass to fix the aorta with a graft, followed by flap repair of the esophagus.
Host summaryEm Gootee summarizes what Dr. Aaron Garrison said — not the host's own clinical position4:10 ↗
For high-risk patients (less than 5 years old, larger battery size), endoscopic evaluation of the esophagus is recommended because the duration of battery presence higher up than the stomach is unknown.
guidelineAaron Garrison4:30 ↗
The need for ECMO or cardiopulmonary bypass depends on the location of the fistula and whether you can intubate past the injury enough to ventilate during the case.
clinicalAaron Garrison4:43 ↗
If the fistula is near the carina, complex airway reconstruction will be needed and adequate ventilation during the case will not be possible.
clinicalAaron Garrison4:59 ↗
In one case with a large tracheoesophageal fistula, the patient was placed on ECMO because they were unable to adequately ventilate.
clinicalAaron Garrison5:21 ↗
In the Cincinnati Children's case, an interposition graft was performed by removing a segment of trachea and using that trachea as the front wall of the esophagus.
clinicalAaron Garrison5:45 ↗
Button batteries are ingested more than 3500 times per year in the United States.
Host summaryEm Gootee summarizes what Dr. Aaron Garrison said — not the host's own clinical position6:10 ↗
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