With the increase in sales of smaller consumer electronics, there has been a parallel increase in the sale and use of button batteries. These batteries are small and flat and are found in hearing aids, remotes, and electronic games. They are smooth and shiny and very appealing to eat or put up your nose – especially if you’re under 4 years of age.
How Common is This?
Approximately 4000 visits to the emergency department occur each year due to button battery ingestions with a fatality rate of 0.15%.
Why are button batteries so dangerous? When button batteries get stuck near mucosal tissue (like inside the nostril, the esophagus or the stomach lining), a chemical reaction occurs between the battery and the mucosal lining. This chemical reaction called electrolysis results in the leakage of hydroxide (think really strong chemical – like bleach) which causes serious damage like tissue necrosis. If the mucosal area is near a blood vessel – like the aorta (which is a really large blood vessel), there can be erosion into the wall of the aorta resulting in massive hemorrhage and death. If necrosis occurs through the esophageal wall, the outcome isn’t any better.
So what should you do if you think your child ingested a button battery or put one in their nose? First, if they swallowed it, do not give them milk or ipecac. In fact do not give them anything by mouth. Second, try to find the type and size of battery they swallowed. Size matters in button batteries. The larger the button battery, the higher the risk of complications. General rule of thumb is that anything larger than 12 mm is a problem, but all battery ingestions should be taken seriously.
Finally, bring them to the emergency department for evaluation. Button batteries in the nose have to be removed immediately. Button batteries that were
swallowed need an x-ray. An x-ray of your child’s neck, chest and abdomen should be ordered to determine where the button battery is located and if in fact they swallowed a battery (or anything for that matter). I have seen many “negative” x-rays where there is no visible coin or battery from nose to butt.
Button batteries in the esophagus will generally require removal. If the battery is in the stomach, and your child has no symptoms, your doctor may recommend a fishing expedition in your child’s poop to find the battery over the next few days and a follow up x-ray of the abdomen to make sure the battery has been evacuated.
The best medicine is prevention. Keep all button batteries, magnets and any other batteries out of the reach of children.
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