I saw a patient the other night who was having difficulty swallowing and her parent's thought that she had swallowed something. She was a toddler and had been playing with her sister and then suddenly started coughing and having a hard time swallowing. When saw her she seemed to be okay but looked like she was having a hard time swallowing and wouldn't eat or drink. Fortunately she was not having any respiratory distress.
Her parents were not sure of what she might have swallowed, but the first thing that comes to mind is that she might have swallowed a button battery. Button battery ingestions are on the rise as more and more devices like remote controls, games and other household objects use the 3 volt 20 millimeter lithium batteries.
An article in the May issue of Pediatrics reported that there were nearly 66,000 battery related ER visits by children under the age of 18 during a 20 year span. More than 75% of all battery related hospital visits involved children 5 or younger.
Because of the article and her presentation I immediately sent her to the ER for an x-ray to look for a possible ingestion of a foreign body. Ingestion of a button battery is considered a medical emergency so it is important that the diagnosis is made quickly. In most cases the battery will pass into the stomach and then be pooped out.
There are reports of parents finding a battery in the stool and never knowing that the child had ingested a foreign body. But, if the battery lodges in the esophagus it may result in alkaline burns and corrosion and perforation of the esophagus. The longer the battery remains in the esophagus and GI tract the greater the chance for complications.
Good news is that this little girl had swallowed a foreign object, but it was not a battery but a barrette used for her sister's hair. The pediatric ENT doctors were able to scope her and remove the barrette without problems and she is as good as new!
But, if you ever think your child may have swallowed something make sure to consider those button batteries. Better yet, childproof all of those devices in the house by taping them shut and keep all batteries up and out of reach of children. You know a toddler, they will put anything in their mouths, just not the foods that you are trying to get them to eat!
That's your daily dose for today. We'll chat again tomorrow.