Children Swallowing Batteries

Children who swallow disc-shaped batteries should be treated as quickly as possible.
The Los Angeles Times (9/20, Khan) "Booster Shots" blog pointed out that although disc-shaped batteries "should not be part of your child's food pyramid, they're increasingly becoming an issue in our high-tech environment." In addition to the choking hazard, "the alkaline in the power cells can destroy tissue, and small-voltage electrical shocks can cause internal burns." Therefore, children who are suspected of swallowing them "need to be treated as quickly as possible," according to a new paper in the Archives of Otolaryngology -- Head & Neck Surgery.
Dr. Toby Litovitz, director of the National Capital Poison Center, told the AP (9/21, Tanner) that "in the throat, 'the window for safely removing batteries is only two hours.'" And, the NPR (9/20, Hensley) "Shots" blog reported, "because damage to the esophagus can happen quickly, the" current study authors say "it's important for doctors to be on guard for the possibility that a battery could be to blame for children's symptoms," which often include "chest pain, drooling, and lethargy." Notably, such children are "often...misdiagnosed as having respiratory infections."
Before reaching those conclusions, "Stanley J. Kimball of Mount Carmel Health System in Columbus, Ohio, led a review of the treatments of 10 pediatric patients who accidentally swallowed a disc battery at some point between 1998 and 2008," HealthDay (9/20, Mozes) reported. "All 10 cases reviewed by Kimball involved endoscopic retrieval of such discs following X-rays and chest scans," but the "time that elapsed before treatment began ranged from six hours to 30 days."
For example, "two of the patients in the review were seen within three hours of accidentally swallowing a disc battery -- yet severe erosion and transmural necrosis were already present, and one child seen within four hours of ingesting a battery had developed esophageal stenosis," MedPage Today (9/20, Walsh) reported. "In two cases there was considerable delay in diagnosis," and the "authors stated that they found it 'surprising' that some clinicians recommend observation following ingestion of a disc battery, given that life-threatening complications can ensue."
The researchers went to "say that emergency endoscopic retrieval is necessary when children ingest disc batteries, and that a 'multidisciplinary approach involving otolaryngology and pediatric surgery can be very helpful, especially when a tracheoesophageal fistula and/or uncontained perforation is identified,'" WebMD (9/20, Hendrick) reported. Notably, the "American Association of Poison Control Centers reported a total of 2,063 disc battery ingestions in 1998, but that number increased 80% over the next eight years."