Abstract
Objectives While complications from battery ingestion can be severe, especially with the emergence
of stronger battery elements, not all ingestions require prompt removal. We aim to
evaluate a symptom-focused algorithm for battery ingestion that emphasizes observation
over intervention to investigate its safety.
Materials and Methods Patients were identified through a query of foreign-body ingestion radiographs obtained
between 2017 and 2020. A retrospective chart review was then performed of all patients
who presented with button battery ingestions to identify compliance with our algorithm,
overall outcomes, and complications.
Results In total, 2% of all radiographs (44/2,237) demonstrated button battery ingestions.
The median age of patients was 3.8 years (interquartile range, 2.6–5.3). Most batteries
were found in the stomach (64%, n = 28), but were also identified in the esophagus (14%, n = 6), small bowel (14%, n = 6), and colon (9%, n = 4). All esophageal batteries were managed with immediate endoscopic retrieval.
Ten gastric batteries were not managed per protocol, with seven admitted for observation
despite being asymptomatic and repeat abdominal X-rays demonstrating persistent gastric
location of the battery. Four patients underwent esophagogastroduodenoscopy; however,
in two patients the battery had migrated past the stomach prior to intervention. All
small bowel batteries and three of four asymptomatic colon batteries were managed
per protocol; one patient had additional imaging that demonstrated battery passage.
Conclusion Adherence to a symptom-focused protocol for conservative management of button battery
ingestions beyond the gastroesophageal junction is safe and frequently does not require
admission, serial imaging, or intervention.
Keywords
button battery - foreign body ingestion - battery ingestion
