title: Foreign Body Ingestion in Children: Should Button Batteries in the Stomach Be Urgently Removed?
abstract: OBJECTIVE
  Foreign body (FB) ingestion is common in children, and button battery (BB) ingestion has been increasing in recent years. This study was to identify factors related to outcomes of FB ingestion, particularly BBs in the stomach. We evaluated whether the current recommendations are appropriate and aimed to suggest indications for endoscopic removal of BB in the stomach in young children.
  
  
  METHODS
  We investigated patient age, shape, size, location of FBs, spontaneous passage time and resulting complications among 76 children. We observed types, size, location of BB and outcomes, and analyzed their associations with complications.
  
  
  RESULTS
  Coins and BB were the two most common FBs. Their shapes and sizes were not associated with the spontaneous passage time. Size, spontaneous passage time, and age were also not associated with any specific complications. For BB ingestion, all 5 cases with lithium batteries (≥1.5 cm, 3 V) presented moderate to major complications in the esophagus and stomach without any symptoms, even when the batteries were in the stomach and beyond the duodenum, while no complications were noted in 7 cases with alkaline batteries (<1.5 cm, 1.5 V) (p=0.001). All endoscopies were conducted within 24 hours after ingestion.
  
  
  CONCLUSIONS
  The type and voltage of the battery should be considered when determining whether endoscopy is required to remove a BB in the stomach. For lithium battery ingestion in young children, urgent endoscopic removal might be important in order to prevent complications, even if the child is asymptomatic and the battery is smaller than 2 cm.
authors.affiliation: Department of Pediatrics, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea.
authors.forename: Jun Hee
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Department of Pediatrics, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea.
authors.forename: Jee Hoo
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Department of Pediatrics, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea.
authors.forename: Jung Ok
authors.initials: JO
authors.lastname: Shim
authors.affiliation: Department of Pediatrics, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea.
authors.forename: Jung Hwa
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Department of Pediatrics, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea.
authors.forename: Baik-Lin
authors.initials: BL
authors.lastname: Eun
authors.affiliation: Department of Pediatrics, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea.
authors.forename: Kee Hwan
authors.initials: KH
authors.lastname: Yoo
keywords: Button battery; Endoscopy; Foreign bodies; Ingestion