Mubarak, Amani, Benninga, Marc A., Broekaert, Ilse, Dolinsek, Jernej, Homan, Matjaz, Mas, Emmanuel, Miele, Erasmo, Pienar, Corina, Thapar, Nikhil, Thomson, Mike, Tzivinikos, Christos and de Ridder, Lissy (2021). Diagnosis, Management, and Prevention of Button Battery Ingestion in Childhood: A European Society for Paediatric Gastroenterology Hepatology and Nutrition Position Paper. J. Pediatr. Gastroenterol. Nutr., 73 (1). S. 129 - 137. PHILADELPHIA: LIPPINCOTT WILLIAMS & WILKINS. ISSN 1536-4801

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Abstract

Button batteries (BB) remain a health hazard to children as ingestion might lead to life-threatening complications, especially if the battery is impacted in the esophagus. Worldwide initiatives have been set up in order to prevent and also timely diagnose and manage BB ingestions. A European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) task force for BB ingestions has been founded, which aimed to contribute to reducing the health risks related to this event. It is important to focus on the European setting, next to other worldwide initiatives, to develop and implement effective management strategies. As one of the first initiatives of the ESPGHAN task force, this ESPGHAN position paper has been written. The literature is summarized, and prevention strategies are discussed focusing on some controversial topics. An algorithm for the diagnosis and management of BB ingestions is presented and compared to previous guidelines (NASPGHAN, National Poison Center). In agreement with earlier guidelines, immediate localization of the BB is important and in case of esophageal impaction, the BB should be removed instantly (preferably <2 hours). Honey and sucralfate can be considered in ingestions <= 12 hours while waiting for endoscopic removal but should not delay it. In case of delayed diagnosis (first confirmation of the BB on X-ray >12 hours after ingestion or time point of removal >12 hours after ingestion) and esophageal impaction the guideline suggests to perform a CT scan in order to evaluate for vascular injury before removing the battery. In delayed diagnosis, even if the battery has passed the esophagus, endoscopy to screen for esophageal damage and a CT scan to rule out vascular injury should be considered even in asymptomatic children. In asymptomatic patients with early diagnosis (<= 12 hours after ingestion) and position of the BB beyond the esophagus, one can monitor with repeat X-ray (if not already evacuated in stool) in 7 to 14 days, which is different from previous guidelines where repeat X-ray and removal is recommended after 2-4 days and is also based on age. Finally, prevention strategies are discussed in this paper.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Mubarak, AmaniUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Benninga, Marc A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Broekaert, IlseUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Dolinsek, JernejUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Homan, MatjazUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mas, EmmanuelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Miele, ErasmoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Pienar, CorinaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Thapar, NikhilUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Thomson, MikeUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Tzivinikos, ChristosUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
de Ridder, LissyUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-604744
DOI: 10.1097/MPG.0000000000003048
Journal or Publication Title: J. Pediatr. Gastroenterol. Nutr.
Volume: 73
Number: 1
Page Range: S. 129 - 137
Date: 2021
Publisher: LIPPINCOTT WILLIAMS & WILKINS
Place of Publication: PHILADELPHIA
ISSN: 1536-4801
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
CHILDREN; INJURIES; COMPLICATIONS; DAMAGEMultiple languages
Gastroenterology & Hepatology; Nutrition & Dietetics; PediatricsMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/60474

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