Skip to content
2000
Volume 31, Issue 42
  • ISSN: 1381-6128
  • E-ISSN: 1873-4286

Abstract

Ingestion of button batteries (BB) represents a substantial health hazard, causing more common and severe complications than most other ingested objects. While the primary mechanism of injury is alkaline caustic injury (mediated by hydroxide ions produced through electrolysis at the site of the button battery), additional pathophysiological processes include pressure-induced necrosis, accumulation of hydroxide compounds at the battery’s negative pole, direct caustic tissue injury, and potential heavy metal toxicity. Full-thickness burns, esophageal perforation, tracheoesophageal and aortoesophageal fistulas are encountered shortly after exposure. Vocal cord paralysis due to BB ingestion appears to be an early sign to predict the severity of the condition. Besides expedient removal, mitigation strategies are the key to the management. Pre-BB removal using honey or sucralfate and post-removal sterile acetic acid irrigation in the operation room can alleviate complication rates. This review is intended to cover and summarize all aspects of these incidents to provide information to clinicians and healthcare personnel.

© 2025 Bentham Science Publishers
Loading

Article metrics loading...

/content/journals/cpd/10.2174/0113816128361865250411045020
2025-04-25
2025-10-27

  • From This Site

    /content/journals/cpd/10.2174/0113816128361865250411045020
    dcterms_title,dcterms_subject,pub_keyword
    -contentType:Contributor -contentType:Concept -contentType:Institution
    10
    5
Loading full text...

Full text loading...

References

  1. GreyN.E.O. MaloneL.J. MillerA.L. CarrollH.F. KhalafR.T. KramerR.E. BrowneL.P. Magnetic resonance imaging findings following button battery ingestion.Pediatr. Radiol.202151101856186610.1007/s00247‑021‑05085‑w34075452
     [Google Scholar]
  2. EliasonM.J. MelzerJ.M. WintersJ.R. GallagherT.Q. Identifying predictive factors for long-term complications following button battery impactions: A case series and literature review.Int. J. Pediatr. Otorhinolaryngol.20168719820210.1016/j.ijporl.2016.06.01627368471
     [Google Scholar]
  3. CairnsR. BrownJ.A. LachireddyK. WylieC. RobinsonJ. DawsonA.H. BuckleyN.A. Button battery exposures in Australian children: A prospective observational study highlighting the role of poisons information centres.Clin. Toxicol.201957640441010.1080/15563650.2018.153749230663910
     [Google Scholar]
  4. LitovitzT. WhitakerN. ClarkL. WhiteN.C. MarsolekM. Emerging battery-ingestion hazard: Clinical implications.Pediatrics201012561168117710.1542/peds.2009‑303720498173
     [Google Scholar]
  5. SharpeS.J. RochetteL.M. SmithG.A. Pediatric battery-related emergency department visits in the United States, 1990-2009.Pediatrics201212961111111710.1542/peds.2011‑001222585763
     [Google Scholar]
  6. LeinwandK. BrumbaughD.E. KramerR.E. Button battery ingestion in children.Gastrointest. Endosc. Clin. N. Am.20162619911810.1016/j.giec.2015.08.00326616899
     [Google Scholar]
  7. The hazards of button batteries.2021Available from: https://www.aap.org/en-us/advocacy-and-policy/aap-health-initiatives/Pages/Button-Battery.aspx
  8. ChandlerM.D. IlyasK. JatanaK.R. SmithG.A. McKenzieL.B. MacKayJ.M. Pediatric battery-related emergency department visits in the United States: 2010–2019.Pediatrics20221503e202205670910.1542/peds.2022‑05670936032018
     [Google Scholar]
  9. TranC. NunezC. EslickG.D. BarkerR. ElliottE.J. Complications of button battery ingestion or insertion in children: A systematic review and pooled analysis of individual patient-level data.World J. Pediatr.202420101017102810.1007/s12519‑024‑00833‑y39168931
     [Google Scholar]
  10. KromH. VisserM. HulstJ.M. WoltersV.M. Van den NeuckerA.M. de MeijT. van der DoefH.P.J. NorbruisO.F. BenningaM.A. SmitM.J.M. KindermannA. Serious complications after button battery ingestion in children.Eur. J. Pediatr.201817771063107010.1007/s00431‑018‑3154‑629717359
     [Google Scholar]
  11. HoaglandM.A. IngR.J. JatanaK.R. JacobsI.N. ChatterjeeD. Anesthetic implications of the new guidelines for button battery ingestion in children.Anesth. Analg.2020130366567210.1213/ANE.000000000000402930829672
     [Google Scholar]
  12. SpeidelA.J. WölfleL. MayerB. PosovszkyC. Increase in foreign body and harmful substance ingestion and associated complications in children: A retrospective study of 1199 cases from 2005 to 2017.BMC Pediatr.202020156010.1186/s12887‑020‑02444‑833339520
     [Google Scholar]
  13. EttyreddyA.R. GeorgM.W. ChiD.H. GainesB.A. SimonsJ.P. Button battery injuries in the pediatric aerodigestive tract.Ear Nose Throat J.2015941248649310.1177/01455613150940120726670755
     [Google Scholar]
  14. JatanaK.R. RhoadesK. MilkovichS. JacobsI.N. Basic mechanism of button battery ingestion injuries and novel mitigation strategies after diagnosis and removal.Laryngoscope201712761276128210.1002/lary.2636227859311
     [Google Scholar]
  15. TanakaJ. YamashitaM. YamashitaM. KajigayaH. Effects of tap water on esophageal burns in dogs from button lithium batteries.Vet. Hum. Toxicol.199941527928210509426
     [Google Scholar]
  16. LorenzoM. BenoS. Evolving threat of pediatric ingestions: A discussion of cannabis and button batteries and their implications for children.Curr. Opin. Pediatr.202335331632310.1097/MOP.000000000000123836876321
     [Google Scholar]
  17. ButtazzoniE. GregoriD. PaoliB. SorianiN. BaldasS. RodriguezH. LorenzoniG. Symptoms associated with button batteries injuries in children: An epidemiological review.Int. J. Pediatr. Otorhinolaryngol.201579122200220710.1016/j.ijporl.2015.10.00326520908
     [Google Scholar]
  18. AnandS. JainV. AgarwalaS. DhuaA.K. YadavD.K. Esophageal button battery in the pediatric population: Experience from a tertiary care center.Indian J. Pediatr.202087859159710.1007/s12098‑020‑03222‑132062820
     [Google Scholar]
  19. PhilteosJ. JamesA.L. PropstE.J. OstrowO. McKinnonN. EverettT. WolterN.E. Airway complications resulting from pediatric esophageal button battery impaction.JAMA Otolaryngol. Head Neck Surg.2022148767768310.1001/jamaoto.2022.084835616924
     [Google Scholar]
  20. DuanQ. ZhangF. WangG. WangH. LiH. ZhaoJ. ZhangJ. NiX. Vocal cord paralysis following lithium button battery ingestion in children.Eur. J. Pediatr.202118041059106610.1007/s00431‑020‑03830‑133048238
     [Google Scholar]
  21. XuG. JiaD. ChenJ. PanH. WuZ. Esophageal button battery impactions in children: An analysis of 89 cases.BMC Pediatr.202424138810.1186/s12887‑024‑04869‑x38851720
     [Google Scholar]
  22. YanS. ChenG. ZengN. GaoC. Characteristics and treatment of pediatric nasal foreign bodies with button batteries-A retrospective analysis of 176 cases.PLoS One2024198e030926110.1371/journal.pone.030926139208061
     [Google Scholar]
  23. LiaoW. WenG. ZhangX. Button battery intake as foreign body in Chinese children: Review of case reports and the literature.Pediatr. Emerg. Care201531641241510.1097/PEC.000000000000013424732349
     [Google Scholar]
  24. KieferA. DuppelU. SchützenmeierA. LangT. KittelJ. KabeschM. KerzelS. Button battery ingestions cause the majority of severe complications.Klin. Padiatr.20232352909710.1055/a‑2007‑168636758576
     [Google Scholar]
  25. ZhangFZ DuanQC WangGX Clinical characteristics and serious complications of esophageal button battery ingestion in the pediatric on 83 cases.Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi202358548148510.3760/cma.j.cn115330‑20221026‑00632
     [Google Scholar]
  26. HoltestaulT. FrankoJ. EscobarM.A.Jr BarlowM. Pediatric ingestions.Surg. Clin. North Am.2022102577979510.1016/j.suc.2022.07.00936209745
     [Google Scholar]
  27. DemirorenK. Management of gastrointestinal foreign bodies with brief review of the guidelines.Pediatr. Gastroenterol. Hepatol. Nutr.202326111410.5223/pghn.2023.26.1.136816435
     [Google Scholar]
  28. SinclairE.M. SantoreM.T. AgarwalM. KitzmanJ. SauerC.G. RiedeselE.L. Evolving clinical care in esophageal button batteries.J. Pediatr. Gastroenterol. Nutr.202274223624310.1097/MPG.000000000000334634724451
     [Google Scholar]
  29. TambakisG. SchildkrautT. DelaneyI. GilmoreR. LoebensteinM. TaylorA. HoltB. TsoiE.H. CameronG. DemediukB. MillerA. ConnellW. WrightE. ThompsonA. HolmesJ. Management of foreign body ingestion in adults: Time to stop and rethink endoscopy.Endosc. Int. Open20231112E1161E116710.1055/a‑2201‑692838094028
     [Google Scholar]
  30. ZongY. ZhaoH. SunC. JiM. WuY. ZhangS. WangY. Differences between intentional and accidental ingestion of foreign body in China.BMC Gastroenterol.20202019010.1186/s12876‑020‑01224‑z32252651
     [Google Scholar]
  31. HuangB.L. RichH.G. SimundsonS.E. DhinganaM.K. HarringtonC. MossS.F. Intentional swallowing of foreign bodies is a recurrent and costly problem that rarely causes endoscopy complications.Clin. Gastroenterol. Hepatol.201081194194610.1016/j.cgh.2010.07.01320692368
     [Google Scholar]
  32. SempleT. CalderA.D. RamaswamyM. McHughK. Button battery ingestion in children—A potentially catastrophic event of which all radiologists must be aware.Br. J. Radiol.20189110812016078110.1259/bjr.2016078128830198
     [Google Scholar]
  33. CockrellH.C. GreenbergS.L.M. KnightJ.A. GreenN.F. RombergE.K. Bonilla-VelezJ. ChapmanT. Magnetic resonance imaging of children following esophageal button battery removal: What are we looking for?Clin. Imaging202286717410.1016/j.clinimag.2022.03.01335364444
     [Google Scholar]
  34. AtlasN. SinclairE.M. SimonH.K. RiedeselE.L. FigueroaJ. KamatP.P. SantoreM.T. Management of esophageal button battery ingestions: Resource utilization and outcomes.Pediatr. Surg. Int.202238347347810.1007/s00383‑021‑05058‑y35088154
     [Google Scholar]
  35. WangZ. DuZ. ZhouX. ChenT. LiC. Misdiagnosis of peripheral abscess caused by duodenal foreign body: A case report and literature review.BMC Gastroenterol.202020123610.1186/s12876‑020‑01335‑732703254
     [Google Scholar]
  36. VaucelJA RecherM ParadisC Severe post-pyloric injury after button battery ingestion: Systematic literature review and case report.Arch Pediatr.202330750150410.1016/j.arcped.2023.05.007
     [Google Scholar]
  37. MubarakA. BenningaM.A. BroekaertI. DolinsekJ. HomanM. MasE. MieleE. PienarC. ThaparN. ThomsonM. TzivinikosC. de RidderL. Diagnosis, management, and prevention of button battery ingestion in childhood.J. Pediatr. Gastroenterol. Nutr.202173112913610.1097/MPG.000000000000304833555169
     [Google Scholar]
  38. Al LawatiT.T. Al MarhoobiR.M. Timing of button battery removal from the upper gastrointestinal system in children.Pediatr. Emerg. Care2021378e461e46310.1097/PEC.000000000000169730601350
     [Google Scholar]
  39. SethiaR. GibbsH. JacobsI.N. ReillyJ.S. RhoadesK. JatanaK.R. Current management of button battery injuries.Laryngoscope Investig. Otolaryngol.20216354956310.1002/lio2.53534195377
     [Google Scholar]
  40. AnfangR.R. JatanaK.R. LinnR.L. RhoadesK. FryJ. JacobsI.N. pH-neutralizing esophageal irrigations as a novel mitigation strategy for button battery injury.Laryngoscope20191291495710.1002/lary.2731229889306
     [Google Scholar]
  41. AnfangR.R. JatanaK.R. LinnR.L. RhoadesK. FryJ. JacobsI.N. In response to pH-neutralizing esophageal irrigations as a novel mitigation strategy.Laryngoscope20191295E163E16410.1002/lary.2775430746705
     [Google Scholar]
  42. LernerD.G. BrumbaughD. LightdaleJ.R. JatanaK.R. JacobsI.N. MamulaP. Mitigating risks of swallowed button batteries.J. Pediatr. Gastroenterol. Nutr.202070554254610.1097/MPG.000000000000264932022776
     [Google Scholar]
  43. JatanaK.R. BarronC.L. JacobsI.N. Initial clinical application of tissue pH neutralization after esophageal button battery removal in children.Laryngoscope201912981772177610.1002/lary.2790430835848
     [Google Scholar]
  44. Battery ingestion triage and treatment guideline.2018Available from: https://www.poison.org/~/media/files/poisonorg/battery/battery-guideline-2019-4-for-web.pdf?la=en
  45. American college of surgeons: Clinical congress 2019. 2019Available from: https://www.globalirc.org/news/american-college-of- surgeons-clinical-congress-2019
  46. AkinkugbeO. JamesA.L. OstrowO. EverettT. WolterN.E. McKinnonN.K. Vascular complications in children following button battery ingestions: A systematic review.Pediatrics20221503e202205747710.1542/peds.2022‑05747736032017
     [Google Scholar]
  47. LitovitzT. WhitakerN. ClarkL. Preventing battery ingestions: An analysis of 8648 cases.Pediatrics201012561178118310.1542/peds.2009‑303820498172
     [Google Scholar]
  48. LorenzoC. AzevedoS. LopesJ. FernandesA. LoretoH. MouratoP. LopesA.I. Battery ingestion in children, an ongoing challenge: Recent experience of a tertiary center.Front Pediatr.20221084809210.3389/fped.2022.84809235573958
     [Google Scholar]
  49. TiryakiT. LivanelioğluZ. AtayurtH. Early bougienage for relief of stricture formation following caustic esophageal burns.Pediatr. Surg. Int.2005212788010.1007/s00383‑004‑1331‑315619090
     [Google Scholar]
  50. EliasonM.J. RiccaR.L. GallagherT.Q. Button battery ingestion in children.Curr. Opin. Otolaryngol. Head Neck Surg.201725652052610.1097/MOO.000000000000041028858893
     [Google Scholar]
  51. GohS. SiuJ.M. PhilteosJ. JamesA.L. OstrowO. McKinnonN.K. EverettT. LevineM. WhyteH. LamC.Z. PropstE.J. WolterN.E. Pediatric esophageal button battery protocol reduces time from presentation to removal.Laryngoscope2024134125170517710.1002/lary.3160738934450
     [Google Scholar]
  52. Poison control button battery ingestion triage and treatment guideline.2018Available from: https://www.poison.org/battery/guideline
  53. DembińskiŁ. CopleyS. KoletzkoB. GrossmanZ. del TorsoS. Mujkić-KlarićA. HadjipanayisA. European paediatricians need to be more aware of the risks faced by children who swallow button batteries and how to treat them.Acta Paediatr.2024113122658266310.1111/apa.1739339166798
     [Google Scholar]
  54. KramerR.E. LernerD.G. LinT. ManfrediM. ShahM. StephenT.C. GibbonsT.E. PallH. SahnB. McOmberM. ZacurG. FriedlanderJ. QuirosA.J. FishmanD.S. MamulaP. Management of ingested foreign bodies in children: A clinical report of the NASPGHAN endoscopy committee.J. Pediatr. Gastroenterol. Nutr.201560456257410.1097/MPG.000000000000072925611037
     [Google Scholar]
  55. ShudyM. de AlmeidaM.L. LyS. LandonC. GroftS. JenkinsT.L. NicholsonC.E. Impact of pediatric critical illness and injury on families: A systematic literature review.Pediatrics2006118Suppl. 3S203S21810.1542/peds.2006‑0951B17142557
     [Google Scholar]
  56. ClarkM.E. CummingsB.M. KuhlthauK. FrassicaN. NoviskiN. Impact of pediatric intensive care unit admission on family financial status and productivity: A pilot study.J. Intensive Care Med.20193411-1297397710.1177/088506661772327828797189
     [Google Scholar]
  57. Button battery ingestion statistics from National Poison Data System.2024Available from: www.poison.org/battery/stats
  58. JatanaK.R. ChaoS. JacobsI.N. LitovitzT. Button battery safety.Otolaryngol. Clin. North Am.201952114916110.1016/j.otc.2018.08.00930309675
     [Google Scholar]
  59. SpinnerJ. Energizer charges into child-resistant packaging.2010Available from: www.packagingdigest.com/packaging-design/ energizercharges-child-resistant-packaging
  60. Lithium coin battery safety2016Available from: https://www.duracell-me.com/technology/lithium-coin-battery-safety/
  61. Coin lithium battery safety.2018Available from: http://www.energizer.com/responsibility/coin-lithium-battery-safety/preventing-coin-lithium-battery-injury?page5register
  62. ChaoS. GibbsH. RhoadesK. MehrerC. JacobsI.N. JatanaK.R. Button battery taping and disposal: Risk reduction strategies for the household setting.Int. J. Pediatr. Otorhinolaryngol.202215311100810.1016/j.ijporl.2021.11100834986444
     [Google Scholar]
  63. LahmarJ. CélérierC. GarabédianE.N. CouloignerV. LeboulangerN. DenoyelleF. Esophageal lesions following button-battery ingestion in children: Analysis of causes and proposals for preventive measures.Eur. Ann. Otorhinolaryngol. Head Neck Dis.20181352919410.1016/j.anorl.2017.09.00429054752
     [Google Scholar]
/content/journals/cpd/10.2174/0113816128361865250411045020
Loading
A Killer in Disguise: Button Battery Ingestions in Acute Care
Curr. Pharm. Des. 31, 3347 (2025); https://doi.org/10.2174/0113816128361865250411045020
/content/journals/cpd/10.2174/0113816128361865250411045020
/content/journals/cpd/10.2174/0113816128361865250411045020
Loading

Data & Media loading...


  • Article Type:     Review Article
Keyword(s): Button battery; button battery ingestion; honey; impaction; tracheoesophageal fistula; vocal cord paralysis

Most Cited Most Cited RSS feed

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error
Please enter a valid_number test