2020 Volume 56 Issue 2 Pages 183-187
Purpose: The accidental ingestion of coin-type lithium batteries has been observed to result in severe gastrointestinal disorders such as esophagotracheal fistula. A warning on this matter has been included on the Japan Society of Pediatric Surgery website; however, accidents continue to occur. Owing to a lack of detailed data, such as the number of cases and their severity, we decided to conduct a nationwide survey.
Methods: We conducted surveys at 202 facilities affiliated with the Japanese Society of Pediatric Surgery, Japanese Society for Pediatric Emergency Medicine, and Japanese Society for Pediatric Endoscopy. The questions included the (1) number of cases of accidental ingestion of button or coin-type batteries at each facility in the five-year period between January 1, 2011 and December 31, 2015, (2) type of battery in each case (button or coin type), (3) location of the battery at the time of discovery (esophagus, stomach, or beyond the duodenum), (4) how the battery was extracted (natural excretion, magnet, endoscopy, others), and (5) prognosis (good/bad; complications such as stenosis or perforation).
Results: We received replies from 116 facilities (57.4%). A total of 939 cases of accidental ingestion of batteries were encountered, 806 involved button-type batteries and 133 coin-type batteries. Only one (8.3%) of the 12 cases of accidental ingestion of button-type batteries that were lodged in the esophagus resulted in a gastrointestinal disorder. Furthermore, none of the cases in which the batteries were discovered in the stomach resulted in any gastrointestinal disorders (excluding the six cases whose prognoses were unknown). Similarly, none of the cases in which the batteries were discovered in the duodenum or beyond resulted in any gastrointestinal disorders (excluding the two cases whose prognoses were unknown). Of the 45 cases of accidental ingestion of coin-type batteries discovered in the esophagus, 14 (31.1%) were observed to have resulted in gastrointestinal disorders. No damage was found in the 71 cases in which the coin-type batteries were discovered in the stomach (disregarding the two cases whose prognoses were unknown), and no damage was found in the 17 cases in which the batteries passed the duodenum.
Conclusions: We can conclude that, in cases of accidental ingestion of button-type batteries, it is essential to check both the battery’s location in the body and the battery type. Moreover, immediate extraction is advisable in cases in which a coin-type battery is determined to be stuck in a patient’s esophagus.
