Perioperative management of button battery ingestions in children (February 2022)

Summary

Foreign body ingestions are common events among paediatric patients. Button battery ingestions are particularly dangerous. Although the incidence of button battery ingestions has not changed over the last 30 years, the rates of emergency department visits, major morbidity, and mortality have risen dramatically since the introduction of the 3-volt–20 mm lithium batteries in 2006. These batteries are larger and more powerful than their predecessors, which has increased the incidence of esophageal impaction and significant tissue injury.  The overall incidence of major morbidity or mortality after button battery ingestion is 0.42%. However, in children under six years old who ingest batteries >20 mm, the rates of major complications are as high as 12.6%. All reported fatalities have occurred in children under five years old. This article in the Anesthesia Patient Safety Foundation newsletter looks at the perioperative management of children who have ingested a button battery.