Current guidelines for treatment after button battery ingestion

Aim: Button battery ingestion is one of the most dangerous forms of foreign body ingestion commonly seen in paediatrics. It poses a serious threat to both the health and life of children. The extent of the damage depends on the duration of contact between the battery and the oesophageal mucosa, the pressure exerted by the foreign body on the oesophageal wall, the local electric current flow, and the potential leakage of toxic substances. Complications following battery exposure include oesophageal burns and perforation, oesophageal-tracheal fistula, oesophageal-aortic fistula, mediastinitis, gastric perforation, intestinal perforation, and peritonitis. Long-term complications are oesophageal strictures, while rare complications include vocal fold paralysis and spinal injury. The aim of this study is to establish updated guidelines for the management of children in cases of button battery ingestion. Materials and methods: A comprehensive literature search was performed for the years 2018–2023. Results: A total of 1,057 children treated after for button battery ingestion were included in the study. Among the patients, 309 were found to have a button battery lodged in the oesophagus, while in the remaining 748 children, the foreign body was located in the stomach, duodenum, or small intestine. The patients’ epidemiological data, clinical manifestations, radiological findings, treatment, complications, and long-term outcomes were analysed. Current management guidelines based on National Capital Poison Center recommendations and literature data from recent years were presented. Conclusions: Button battery ingestion is one of the most dangerous forms of foreign body ingestion commonly seen in the paediatric population. The longer the foreign body is lodged in the oesophagus, the higher the risk of complications. Once the battery is removed from the oesophagus, the injury may continue to develop for up to several weeks, causing distant complications. Preventive measures to reduce the risk of battery ingestion incidents are essential.