According to an article published by the American Academy of Pediatrics in 2010, severe and fatal battery ingestions are increasing, and many patients are being treated inadequately for button battery ingestions. From 1985 to 1009, there has been a 6-fold increase in button battery ingestions with resulting major or fatal outcomes. The largest increase has been with lithium-cell batteries (24% of ingestions) and 20-25mm diameter batteries (18% of ingestions). 20mm lithium cells are the most common to be associated with severe outcomes.
A high index of suspicion is needed; 54% of fatal outcomes are misdiagnosed, usually complicated by nonspecific presentations. Most serious battery ingestions are not witnessed. Consider an ingestion anytime a patient is wheezing, drooling, vomiting, or has chest pain or discomfort.
Evaluating a battery ingestion
Keep the patient NPO until an esophageal foreign body is ruled out with imaging.