Swallowed button batteries sent more than 7,000 kids to the ED in the past 10 years, more than twice the number in the previous decade. Review the emergency protocols for this presentation.
Children younger than 6 years account for 61% of ingestions, with a peak incidence in those aged 1 and 3 years. All fatalities from 1985-2009 and 85% of cases with major outcomes occurred in children who were younger than 4 years old and were often nonverbal.A second peak is observed in adults older than 60 years, with 10.3% of cases occurring in patients aged 60-89 years.Elderly patients are more likely to have batteries lodged in the small or large bowels.
Complications in major outcome cases have included tracheoesophageal fistulas, other esophageal perforations, esophageal strictures requiring repeated dilations, vocal cord paralysis from recurrent laryngeal nerve damage, mediastinitis, pneumothorax, pneumoperitoneum, tracheal stenosis, tracheomalacia, aspiration pneumonia, empyema, lung abscess, and spondylodiscitis.The possibility of heavy metal poisoning, especially from mercury, has been considered.
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