Disk battery ingestion: case series with assessment of clinical and financial impact of a preventable disease.
BACKGROUND
Commonly, foreign objects are incidentally ingested and pass harmlessly through the gastrointestinal tract; however, disk batteries present exceptional risk. In 2009, the American Association of Poison Control Centers listed disk batteries as the number 1 cause of fatal ingestions in children younger than 5 years. Lithium batteries are the most dangerous, and they are rapidly rising in use by manufacturers. Paralleling that rise, there has been a 6.7-fold increase in major or fatal outcomes between 1985 and 2009. This study describes the variability in patient presentations, the courses of patients' evaluations, and the clinical and financial consequences of disk battery ingestion.


METHODS
In this retrospective study, cases from 2001 to 2011 were reviewed for details of care for disk battery ingestions including presentation and management details. Cost of care information from our patients' records was compared with that of national averages on esophageal foreign bodies using the Healthcare Cost and Utilization Project's Kids' Inpatient Database.


RESULTS
Six cases are presented. The patients' age averaged 1.85 years. Presentations varied with respect to symptoms, time course, and steps in treatment. Mean length of stay was 9.0 days, and mean cost was $14,994.


CONCLUSIONS
Emergency medicine physicians, otolaryngologists, radiologists, gastroenterologists, and pediatric surgeons may be able to mitigate, albeit not entirely prevent, potential serious complications in patients with disk battery ingestions by proper diagnosis and timely treatment. Recommendations for management are presented, which highlight the need for emergent removal of any battery that is lodged and close follow-up of these patients once they are out of the hospital.
Wake Forest™ School of Medicine, WFUBMC-OHNS, Medical Center Boulevard, Winston-Salem, NC 27157, USA.
Nicholas J
NJ
Panella
Daniel J
DJ
Kirse
Thomas
T
Pranikoff
Adele K
AK
Evans
D002675:Child, Preschool; D004435:Eating; D011211:Electric Power Supplies / Q000009:adverse effects*; D004636:Emergency Service, Hospital; D004945:Esophagoscopy; D005260:Female; D005547:Foreign Bodies / Q000175:diagnosis* / Q000628:therapy*; D017048:Health Care Costs; D006801:Humans; D007223:Infant; D007902:Length of Stay / Q000706:statistics & numerical data; D008094:Lithium / Q000506:poisoning; D008297:Male; D012189:Retrospective Studies
D008094:Lithium