Post written by Racha T. Khalaf, MD, from the Digestive Health Institute & Section of Pediatric Gastroenterology, Hepatology and Nutrition, Children’s Hospital Colorado, University of Colorado School of Medicine, Aurora, Colorado, USA.

Through our study, we wanted to better define the spectrum of injury and understand which clinical factors are associated with injury from retained gastric button batteries in pediatric patients.

Per our societal and poison control guidelines, removal of a gastric button battery remains controversial and is left at the discretion of the treating physician.  Following discussion with our colleagues across the country at major academic institutions, we realized that we have all seen adverse events and gastric injury from retained batteries removed endoscopically from the stomach. We decided to collect this data and report on it when one patient at the Children’s Hospital in Colorado had a gastric perforation from a battery, so we can better inform physicians treating patients with retained gastric batteries about the risks and associated factors leading to injury.

Our analysis of a cohort of 68 pediatric patients with retained gastric button batteries leading to endoscopic intervention shows that these foreign bodies pose a risk of injury to the stomach mucosa. Surprisingly, symptoms at the time of presentation did not correlate with gastric injury, but time to removal of the battery did regardless of age. Individuals undergoing endoscopic intervention within 12 hours of ingestion had a significantly lower risk of mucosal injury. Larger studies are needed to assess the risk of injury.

Figure 1. Endoscopic images of patients with gastric button batteries (BBs) before and after endoscopic removal. A-D, BBs lodged in the antropyloric region in 4 separate patients. There are notable erosions, erythema, and necrosis surrounding the BBs in these images. E-H, Corresponding images after battery removal. Linear erosions, erythema, bleeding, edema, and necrosis at the site of prior battery adhesion are seen in these images.

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