Introduction
Button battery ingestions (BBI) are increasingly common. The ESPGHAN position paper on BBI was published in 2021 outlining procedures for the diagnosis and management of BBI. Despite rising cases, the true global incidence of BBI is underreported.
Aims & Methods
An online survey was distributed via the monthly ESPGHAN newsletter between May and February 2023, requesting details about BBI cases managed the last 3
years.
Results
A total of 177 responses were received (82% paediatric gastroenterologists) with most practicing in Europe (64) or North America (69). The total number of BBI cases managed by respondents was 1830 with 28.6% of cases involving a large (>20mm) button battery (BB) and 21 reported deaths.
38% of responders reported increasing numbers of BBI cases. Honey for children > 12 months of age is recommended within 12 hours post ingestion for oesophageal impaction but was not used by 70% of doctors (Fig.1.A). Acetic acid irrigation immediately after removing the button battery was also not used by 76.5% of responders (Fig.1.B). Only 56% of responders reported placing a nasogastric tube after BB removal and 56.1% performed contrast study after 1-2 days. Significant variability was noted in timing of initiating oral feeds post-BB removal (44% reported starting oral feeds after 24 hours, 37% within the first 24 hours, 19% deferred starting until seeing a normal contrast study (Fig.1.C). Nearly half of the cases required admission <2 days: (43.7%). 1281 cases (70%) experienced full recovery without complications. However, the remaining 30% developed complications: strictures; dysphagia; fistulas (Fig.1.D). More than 80% of doctors were aware of the ESPGHAN BBI position paper, but their practice varies widely.
Conclusion
BBI cases are increasing, and children continue to die. We propose a pan-European prospective registry with global reach to better evaluate incidence and outcomes and further, inform management and prevention.
References
1. Mubarak A, Benninga MA, Broekaert I, Dolinsek J, Homan M, Mas E, Miele E, Pienar C, Thapar N, Thomson M, Tzivinikos C, de Ridder L. Diagnosis, Management, and Prevention of Button Battery Ingestion in Childhood: A European Society for Paediatric Gastroenterology Hepatology and Nutrition Position Paper. J Pediatr Gastroenterol Nutr. 2021 Jul 1;73(1):129-136.
2. Chandler MD, Ilyas K, Jatana KR, Smith GA, McKenzie LB, MacKay JM. Pediatric Battery-Related Emergency Department Visits in the United States: 2010-2019. Pediatrics. 2022 Sep 1;150(3):e2022056709
Disclosure
nil to disclose