Button batteries: Often swallowed, seldom fatally

One day in April 2013, Tammy Zahn went to play a DVD of the movie Rio for her sons, Christopher, 7, and Jacob, 5. When Zahn picked up the remote, she noticed the plastic latch at the back was missing, and so was the little battery.

She checked the bedroom floor. Then she looked at her sons.

“Christopher, where’s the battery?”

“Momma, please don’t be mad at me,” he said. “But I accidentally swallowed it.” And his stomach hurt. Zahn strapped Christopher into his car seat and raced through their hometown, Milwaukee, to Children’s Hospital of Wisconsin.

Doctors X-rayed Christopher. They had little trouble spotting the small, nickel-shaped battery. It was a bright disc, shining in his stomach. Had the battery lodged in his esophagus, the situation would have been deemed an emergency.

X-ray images of so-called button batteries have become a familiar sight at hospitals around the country, despite warning labels on the battery packages. Christopher was one of 3,366 Americans to swallow a button battery in 2013; four died as a result.

“They’re easy for the child to pick up. They’re easy to pop in the mouth and they’re everywhere,” said David Gregg, medical director of imaging at Children’s and the Medical College of Wisconsin.

The potential hazards from these batteries have received increased attention after news reports about an Arizona boy who has gone through 65 surgeries after swallowing a button battery in 2010. Cases have risen as the batteries have become increasingly common, powering hearing aids, remote controls, calculators and novelty greeting cards that sing or play music.

A study reported in the journal Pediatrics found 56,535 incidents of people swallowing button batteries across the nation between 1985 and 2009. Cases resulting in major or fatal injuries increased more than six-fold during the study period.

Although severe injuries are rare, the National Battery Ingestion Hotline reported 16 deaths from button battery swallowing between 1985 and 2013. The batteries can obstruct the food pipe, and stomach acids can cause chemicals from the battery to leak and burn the lining of the esophagus.

The most troublesome of the button batteries are those more than 0.7 inch (20 millimeters) in diameter, which pose a higher risk of getting stuck, and those made of lithium, which is linked to burns, said Farhat N. Ashai-Khan, a pediatric gastroenterologist at Children’s and the Medical College of Wisconsin.

SYMPTOMS

Telltale signs that a child may have swallowed a battery include refusing to eat, coughing, choking or drooling, said Ashai-Khan. If a child is suspected of having swallowed a battery, he should be examined and not given anything to eat or drink until the battery has been removed.

In Christopher’s case, doctors waited overnight to see whether the battery would exit the body on its own.

When morning came and the battery was still in the boy’s stomach, doctors anesthetized him and threaded a tube called an endoscope down his throat and into his stomach. The endoscope carried a tiny camera and doctors were able to follow its progress as it neared the battery. Attached to the end of the tube were small metal forceps, which the doctors used to pluck out the battery. The procedure took about seven minutes.

Tammy Zahn took her son home from the hospital that day.

“He was pretty much right back to his chipper self,” she said. “He’s a spunky one, a true boy, that’s for sure.”