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If Child X-ray Shows Disc Battery, Act Quickly

June 1, 2010
Written by: , Filed in: Pediatric Radiology
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Powerful lithium “button batteries,” found in everything from remote controls and DVD players to thermometers and musical greeting cards, can seriously injure or even kill young children who swallow them.

If a battery lodges in a child’s throat, its current can start a chemical reaction that literally burns through the esophagus. Researchers say that to prevent serious injury, a battery must be removed within two hours of being swallowed. But parents may not notice anything immediately wrong, and eventual symptoms resemble those of the flu: vomiting, fever, coughing, and lack of appetite.

Often, it’s hours or days before an X-ray reveals the battery.

Results of two new studies published in the June issue of Pediatrics highlight the problem and suggest solutions. Toby Litovitz, MD, director of the National Capital Poison Center in Washington, DC, was lead author for both studies.

Dr. Litovitz told HealthDay News:

We’re talking about a really profoundly devastating injury, and sometimes fatalities.

The disc-shaped batteries are 20 millimeters in diameter, thicker than a nickel but not quite as wide. “They are remarkable batteries,” Dr. Litovitz said. “They can pack in three volts, have a long shelf life, and they have more cold tolerance so they can be used in outdoor products.” In 1990, about 1 percent of all 20-millimeter batteries were lithium cells; today, it’s 18 to 20 percent.

Unfortunately, they’re also the perfect size for toddlers to swallow—but large enough to become stuck in a child’s esophagus rather than pass through the digestive system. Dr. Litovitz said she knew of 14 U.S. fatalities since the late 1970s—10 within the past six years.

The New York Times reported on the case of 13-month-old Aidan Truett of Hamilton, Ohio. Doctors thought he had an upper respiratory infection. After nine days, a hospital finally ordered an X-ray to check for pneumonia. Instead, it found a battery.

Doctors surgically removed it and sent Aidan home. Nobody realized that hydroxide created by the current had burned through the esophagus and into the aorta. Two days after the battery was removed, Aidan began coughing blood. He soon died.

Poison-control centers report about 3,500 instances of button battery ingestion annually. Dr. Litovitz and her fellow researchers reviewed more than 8,600 cases. They found that children younger than 6 obtained the battery by removing it from the product it powered in nearly 62 percent of cases. In 30 percent, the children found the batteries loose. In 8 percent, they removed the batteries from battery packaging.

“So to prevent accidents, the single most important thing is to put some burden on the consumer electronics industry that produces battery compartments that are way too easy to open,” Dr. Litovitz said. “And this is not just about toys. It’s the remote control, the watch, the calculator, the scale—typical household items. They need to be secured with a screw and require a screwdriver to open them, so a child can’t get the battery out.

“And parents need to be careful too,” she said. “They should store [the devices] where a child can’t get to them, and when they discard [batteries], make sure they’re out of reach. Parents can also go through the house and identify the products that have this lithium battery, and if the battery compartments aren’t secured, they need to either tape it closed or put it out of reach.”

Related seminar: Pediatric Diagnostic Imaging

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