Gut Feelings - Surprise Inside

By Meredith Hitch, MD, Pediatric Gastroenterologist - Dothan Pediatric Clinic

At times curious children become piggy banks, ingesting coins and other shiny items. A recent case compels me to share the perils of button battery ingestion, which The American Academy of Pediatrics has created a task force.

I was called about a 5 year old who ingested a coin. She had a history of putting items in her mouth and had previously swallowed a coin, which she vomited successfully. X-ray showed this “coin” to be a button battery lodged in her esophagus. The call started her clock, as the esophagus can collapse on button batteries, completing the circuit and generating a current that can char and burn through the esophagus into the aorta resulting in death within as little as two hours!

Her battery took about 1.5 hours to remove. Her petiteness and swelling made removal difficult, but with anesthesia’s help and McGill forceps, it was removed. She had extensive char and swelling in the upper esophagus, demanding intensive care at Children’s of Alabama. She was extubated the next day and tolerated a pureed diet. Her long-term impairment is yet to be determined.

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Each year, more than 3,500 cases of button battery ingestion are reported to U.S. Poison Control Centers. Most cases have a full recovery, but about 3 percent have significant issues later. The number of children suffering serious injury or death has more than quadrupled in the past five years (2006-2010), as we demand more convenient technology. Found in household products like remote controls, cell phones, watches, and digital thermometers, large disc batteries are easily accessible to children.

The clinical presentation of disc battery ingestion varies. Contact length, battery type, and location dictate the severity of aftermath.

While many patients have no symptoms, the most common acute symptoms are non-specific. Nausea, vomiting, drooling, irritability, and abdominal pain appear in about 20 percent of patients.

More severe injuries usually occur when ingestion is unwitnessed and presentation is delayed. In these instances, batteries are more likely to cause perforation and tissue death. Symptoms of these problems are delayed hours to days after ingestion and could include chest pain, difficulty breathing, hoarseness, cough, abdominal pain, bloody stool and vomit, and fever. Other complications include pneumonia, bleeding, infection, breathing and feeding issues.

To read one family’s experience and effort to raise awareness of button battery danger, visit https://emmettsfight.org/

If your child ingests a foreign body, feed him honey en route to the emergency room. Honey reduces injury and improves outcomes by neutralizing the charge. Visit https://www.statpearls.com/

Although Duracel now gives button batteries a bitter taste, keeping them secure and out of the reach of young children is the best prevention.

Meredith Hitch
Author: Meredith Hitch

Dr. Meredith Hitch is a Pediatric Gastroenterologist licensed by the Alabama Board of Medical Examiners and certified by the Pediatric Gastroenterology Medical Board of the American Board of Pediatrics. Dr. Hitch received her Doctor of Medicine degree from St. George’s University School of Medicine, Grenada, West Indies and completed her Pediatric Residency Program at Kosair Children’s Hospital in Louisville, Kentucky. Following her Pediatric Residency, Dr. Hitch completed a three-year Pediatric Gastroenterology Fellowship at St. Louis Children’s Hospital. Upon completion of her Pediatric Gastroenterology Fellowship, Dr. Hitch joined the UAB Division of Pediatric Gastroenterology, Hepatology, and Nutrition at Children’s of Alabama in Birmingham. Most recently, Dr. Hitch served as a member of the Pediatric Gastroenterology Medical Staff at Our Lady of the Lake Children’s Health in Baton Rouge, Louisiana. In November 2019, Dothan Pediatric Healthcare Network welcomed Dr. Hitch as a physician at Dothan Pediatric Subspecialty Clinic. Dr. Hitch’s clinical interests include functional GI disorders, eosinophilic esophagitis, constipation, fatty liver, and obesity.

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Gut Feelings – Surprise Inside

by Meredith Hitch time to read: 3 min