Button battery ER visits on the rise

By Vicki Louk Balint | May 19, 2012

It’s a common complaint seen in pediatric emergency departments, says Jon F. McGreevy, MD, MSPH, of Maricopa Medical Center.

Children between the ages of 6 months to 6 years accidently swallow all types of objects. Coins are the most common, says McGreevy, an AzAAP member. Pins, screws and toy parts also make the list.

Most of these objects pass through the esophagus, stomach and intestines without difficulty or harm. But on occasion, they can get stuck — and usually in the esophagus.

These items all contain button batteries. Photo by Daniel Friedman

The types of objects that children swallow have become more harmful in recent years, says McGreevy. Button batteries, those small, circular batteries usually used to power watches, cameras, calculators, hearing aids and other small electronics, can be extremely dangerous.

A recent study published in the journal Pediatrics showed that number of battery-related emergency department visits is on the rise. Button batteries accounted for 84 percent of all battery-related ingestions among children younger than 18 years of age. The number of emergency visits for button battery ingestion doubled during the study period, which spanned 20 years.

Study authors recommend that prevention efforts be increased, and that they focus on younger children. Parents and caregivers should make sure that the battery compartments of all electronic items are taped shut and loose batteries are always stored out of a child’s reach.

When button batteries are lodged in the esophagus, says McGreevy, they can cause erosion, ulceration and holes in the esophagus in a very short amount of time. They need to be removed or pushed into the stomach as soon as possible. The child is usually watched to make sure they clear the stomach within 48 hours and then it is very unlikely to cause further problems.

Small magnets are also problematic, says McGreevy, who notes that when a child swallows a single magnet, it’s usually not a problem. However, toys with stackable, moldable collections often contain multiples of these small magnets.

When two or more of these small magnets are ingested, they can do what magnets do — attract within the intestines. The pressure can cause obstructions, small holes or a twisting of the intestines around themselves. The only method of removal, says McGreevy, is surgery.

How would you know if a child has swallowed an foreign object? Fortunately, says McGreevy, most ingestions are asymptomatic and will pass. Objects that get stuck cause problems — difficulty with swallowing, or drooling, coughing, vomiting and throat pain. On occasion, these objects can actually fall into the trachea and lungs. That can cause severe breathing difficulties.

What can parents expect from an emergency room visit for a swallowed object? Expect a trial of drinking liquids to help make it pass, or sometimes the use of an intravenous medication. When all else fails, physicians may remove the object in the operating room using a fiber optic camera.