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Rev Recent Clin Trials 2020 Jun 3. Epub 2020 Jun 3.

Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma. Italy.

Introduction: Disk Battery Ingestion (DBI) is a cause of access to the emergency department (ED), especially in pediatric age. This problem, if not well managed, may lead to serious injuries, with several complications involving the gastrointestinal and respiratory tract.

Objective: Aim of this review is to analyze the literature of the last 25 years to make a decisional flow-chart that may help the emergency physician. Read More

Int J Pediatr Otorhinolaryngol 2020 Jan 30;132:109917. Epub 2020 Jan 30.

Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University Hospital Wuerzburg, Josef-Schneider-Str. 11, Wuerzburg, D-97080, Germany. Electronic address:

Objectives: Button battery (BB) ingestion can cause life-threatening complications such as esophageal perforation, and mediastinitis. Chest radiography is the method of choice to diagnose BB ingestion. Therefore, an adequate interpretation of X-ray imaging by physicians is mandatory. Read More

Pediatr Emerg Care 2018 Jul 25. Epub 2018 Jul 25.

Digestive Endoscopy and Surgery Unit-Children's Hospital "Bambino Gesù", Rome, Italy.

Objectives: Disk battery esophageal retention in children younger than 6 years represents an increasing endoscopic emergency, followed by a relevant risk of life-threatening late complications. Surgical removal after a failed endoscopic approach is rarely reported in the literature. We describe our experience in this scenario. Read More

J Am Anim Hosp Assoc 2018 Sep/Oct;54(5):e54501. Epub 2018 Jul 24.

From Veterinary Orthopedics and Sports Medicine Group, Annapolis Junction, Maryland.

A 7 yr old spayed female shih tzu was evaluated for anorexia of 4 days duration. Conservative treatment for gastroenteritis had been administered by another veterinarian 2 days before presentation. Abdominal radiography revealed two round, disk-shaped, metallic-opacity foreign objects within the bowel with loss of serosal detail. Read More

J Pediatr Gastroenterol Nutr 2017 11;65(5):496-499

*National Society of Maritime Rescue †G. Gaslini Institute, Gastroenterology and digestive endoscopy, Genoa ‡BlueThink SpA §Politecnico di Milano, Laboratory of Biological Structure Mechanics ||Anatomy and Histology Department, Grande Ospedale Metropolitano Niguarda, Milan, Italy.

Objectives: Serious and even fatal consequences of disk batteries ingestion in children are well known. Among other applications, disk batteries are used to power small toys, from which they can be unexpectedly extracted and swallowed.

Methods: We tested a new cell intended for little toys (green cell [GC]), after 6 and 12 hours of in vitro close contact with esophageal swine mucosa. Read More

J Emerg Med 2017 Jun 11;52(6):863-866. Epub 2016 Nov 11.

Maimonides Medical Center, Brooklyn, New York.

Background: Pediatric foreign-body ingestions are commonly managed by emergency physicians. Risk assessment and specific intervention are dependent on the nature and location of the foreign body. Radiographic evaluation is usually necessary to help define the clinical situation. Read More

Presse Med 2016 Oct 18;45(10):947-953. Epub 2016 Aug 18.

CHRU de Lille, centre antipoison et toxicovigilance, 5, avenue Oscar-Lambret, 59037 Lille cedex, France.

The ingestion of disc battery is a common problem in children and current treatment may be sometime inadequate. Ingested button batteries have the potential to cause significant morbidity and mortality. Ingestion of button batteries has been seen with increasing frequency over the last decade, particularly for children aged younger than 6 years. Read More

Folia Med Cracov 2016;56(4):21-29

1st Department of Pediatric Surgery, Aristotle University of Thessaloniki, GH G. Gennimatas, 41 Ethnikis Aminis Street, Thessaloniki, Greece.

Aim of the present study is the presentation of our experience in conservative treatment of coin-shaped, ingested foreign bodies in lower esophagus and the consideration about the indications of this method's appliance in clinical practice. From 2011 to 2014, 79 children in total (45 male - 34 female), aged from 8 months to 13 years (average 4.8 years) were admitted to our Department due to foreign body ingestion. Read More

Forensic Sci Med Pathol 2015 Dec 4;11(4):614-7. Epub 2015 Sep 4.

Department of Forensic Medicine, University of Pretoria, Private Bag X323, Arcadia, 0007, South Africa.

Dig Liver Dis 2015 Nov 30;47(11):984-6. Epub 2015 Jul 30.

Emergency Medicine, G. Gaslini, Institute Genoa, Italy.

Background: Over the last years the ingestion of disk batteries has become frequent in children with serious consequences. The severity of injuries is related to the growing use of new lithium batteries that may cause catastrophic damages when lodged in the oesophagus.

Methods: The notes of three consecutive children with lithium batteries lodged in the oesophagus, admitted to our Institute from 2010 to 2014, were reviewed. Read More

Am J Emerg Med 2016 Mar 26;34(3):680.e3-4. Epub 2015 Jun 26.

Naval Medical Center, 620 John Paul Jones Circle, Portsmouth, VA, 23708, USA.

A 4-year-old presented to the emergency department, asymptomatic, with the strong suspicion (by history, physical examination, and initial radiographic interpretation by the emergency physician) of an esophageal coin. Closer inspection revealed radiographic signs associated with disk battery ingestion, a surgical emergency. In the operating room superimposed coins, mimicking the radiographic appearance of a disk (button) battery, were extracted. Read More

Front Psychiatry 2013 13;4:84. Epub 2013 Aug 13.

Schoen Clinic Bad Bramstedt , Bad Bramstedt , Germany.

The aim of the present study was to examine if obese individuals with obesity-related somatic comorbidity (i.e., hypertension, diabetes, sleep apnea, dyslipidemia, pain disorder) perform worse in neurocognitive tasks compared to obese individuals without any somatic disorder. Read More

JAMA Otolaryngol Head Neck Surg 2013 Mar;139(3):304-6

Department of Otolaryngology-Head and Neck Surgery, University of Washington, Seattle, WA 98195, USA.

Importance: Disk battery ingestion is common in the pediatric population, with over 50,000 ingestions reported annually. In the upper aerodigestive tract, consequences of such ingestions vary widely from superficial mucosal ulcerations to death from erosion through vital structures. This report describes a battery ingestion complication, vocal cord paralysis, to our knowledge not previously described in the otolaryngology literature. Read More

Pediatr Emerg Care 2013 Feb;29(2):165-9

Wake Forest™ School of Medicine, WFUBMC-OHNS, Medical Center Boulevard, Winston-Salem, NC 27157, USA.

Background: Commonly, foreign objects are incidentally ingested and pass harmlessly through the gastrointestinal tract; however, disk batteries present exceptional risk. In 2009, the American Association of Poison Control Centers listed disk batteries as the number 1 cause of fatal ingestions in children younger than 5 years. Lithium batteries are the most dangerous, and they are rapidly rising in use by manufacturers. Read More

Arch Otolaryngol Head Neck Surg 2012 Jul;138(7):680-2

Departments of Otolaryngology–Head and Neck Surgery, Loma Linda University Medical Center, CA 92354, USA.

Disk (or button) battery ingestion is not uncommon, with an estimated US incidence of 2 to 8 per million annually.(1) Reported serious adverse sequelae include esophageal stenosis, tracheoesophageal fistula, vocal cord paralysis, massive bleeding, and death.(1,2) There are, however, surprisingly few reports of aspirated batteries in the searchable literature; we found only 2. Read More

Korean J Anesthesiol 2011 Sep 23;61(3):257-61. Epub 2011 Sep 23.

Department of Anesthesiology and Pain Medicine, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea.

Ingestion of disk batteries may have serious complications such as esophageal burn, perforation, and tracheoesophageal fistula, particularly when the battery is caught in the esophagus. Proper placement of the tracheal tube is critical when tracheoesophageal fistula was occurred from esophageal impaction the battery. Endoscopy of upper gastrointestinal tract in infants and children is an important and effective tool for the diagnosis and treatment of foreign body ingestion. Read More

Arch Pediatr 2011 Aug 11;18(8):856-62. Epub 2011 Jun 11.

Unité de gastroentérologie pédiatrique, service de pédiatrie, hôpital mère-enfant, CHU Hassan II de Fès, Fès, Maroc.

The ingestion of a foreign body (FB) is one of the most frequent childhood accidents requiring urgent care depending on the type and localization. Coins are the most frequent, and disk battery ingestion can lead to a significant risk of complications. FB stagnation in the esophagus entails a major risk of perforation. Read More

J Pediatr Surg 2007 Jul;42(7):E39-41

Department of Paediatric Surgery, The Royal Victoria Infirmary, NE1 4LP Newcastle upon Tyne, NE1 4LP United Kingdom.

The authors report a child with tracheoesophageal fistula secondary to disk battery ingestion. With respiratory compromise precluding expectant therapy and primary repair not achievable, gastric interposition and tracheal patch repair were undertaken in the acute phase. To the authors' knowledge, this is the first report of primary gastric interposition for traumatic tracheoesophageal fistula and suggest that immediate reconstruction can give an outcome at least as good as other reported approaches. Read More

J Pediatr Surg 2004 Feb;39(2):243-4

Department of Pediatric Surgery, Osaka Medical Center for Maternal & Child Health, Osaka, Japan.

The authors report on a child with tracheoesophageal fistula secondary to disc battery ingestion. Through a low cervical collar incision with limited sternal split, the fistula was primarily repaired, and the omohyoid muscle and thymus were mobilized to cover the suture lines. There are no signs of recurrent fistula 6 months after the operation. Read More

Auris Nasus Larynx 2003 Dec;30(4):397-401

Department of Otolaryngology, Faculty of Medicine, University of Tokyo, 3-1, Hongo 7-chome, Bunkyo-ku, 113-8655, Tokyo, Japan.

Objective: To investigate pediatric foreign body cases in the aerodigestive tract, and to elucidate the characteristic problems in Japan.

Methods: A total of 310 pediatric patients (age 15 or below), gathered from two medical university hospitals (University of Tokyo and Jichi Medical School), were included in this study. Data were collected by retrospective chart review and were statistically analyzed. Read More

Otolaryngol Head Neck Surg 1999 Sep;121(3):302-3

Division of Otolaryngology, Children's Hospital of Philadelphia, PA 19104, USA.

JAMA 1983 May;249(18):2509-11

JAMA 1983 May;249(18):2504-6

We have treated eight cases of childhood ingestion of alkaline disk batteries, one resulting in an esophagotracheal fistula. These batteries are capable of rapid tissue destruction on contact with moist membranes. We recommend that packaging include proper warning of this hazard and urge that retained batteries be promptly removed from the esophagus and stomach by endoscopy or laparotomy. Read More

JAMA 1983 May;249(18):2502-4