Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.
The Australian Paediatric Surveillance Unit, Level 2, Kids Research, The Sydney Children's Hospital Network (Westmead), Locked Bag 4001, Westmead, NSW, 2145, Australia.
World J Pediatr. 2024 Oct;20(10):1017-1028. doi: 10.1007/s12519-024-00833-y. Epub 2024 Aug 22.
Button battery (BB) exposures are common in children and can have devastating consequences. We reviewed current evidence on the complications associated with BB exposure and identified predictors of outcomes using individual patient-level data.
We carried out a systematic review and pooled analysis by searching MEDLINE, Embase, and Scopus up to May 19, 2023. Included studies describe complications following BB exposures in children (aged < 18 years). Odds ratios (ORs) were calculated using binary logistic regression to measure associations between predictive factors and different outcomes.
Two-hundred seventeen studies (439 children) were included. The median age at presentation was 1.75 [interquartile range (IQR) 1.00-3.00] years and 399 (90.9%) exposures were ingestions. Of the 380 cases reporting sex, 162 (42.6%) were female. Feeding (192, 48.1%) and respiratory difficulties (138, 34.6%) were common presenting features for ingestions, while symptomatology was site-specific for insertions. Common complications included oesophageal mucosal damage alone (105, 26.3%) and tracheooesophageal fistula (93, 23.3%) for ingestions, and nasal septal perforation (22, 55.0%) and mucosal damage alone (13, 32.5%) for insertions. Intestinal perforation occurred in 2.5% of ingestion cases, including perforation of Meckel's diverticulum, peritonitis, and jejunocolic fistula. Vascular complications were common among children who died. Age (≤ 2 years), battery exposure duration (> 6 hours), and battery diameter (≥ 20 mm) were associated with common and severe complications of ingestions.
BB injuries are time-critical, with severe sequelae predominantly affecting young children. Diagnosis is challenging. Preventative work through regulation and safer battery design are required to eliminate this problem.
纽扣电池（BB）暴露在儿童中很常见，可能会产生毁灭性的后果。我们回顾了目前关于 BB 暴露相关并发症的证据，并使用个体患者水平数据确定了结局的预测因素。
我们进行了系统回顾和汇总分析，检索了 MEDLINE、Embase 和 Scopus 截至 2023 年 5 月 19 日的数据。纳入的研究描述了儿童（年龄<18 岁）纽扣电池暴露后的并发症。使用二项逻辑回归计算比值比（OR）来测量预测因素与不同结局之间的关联。
纳入了 217 项研究（439 名儿童）。就诊时的中位年龄为 1.75 岁[四分位距（IQR）1.00-3.00]，399 例（90.9%）暴露为吞食。在报告性别情况的 380 例病例中，162 例（42.6%）为女性。吞食的常见表现为进食困难（192 例，48.1%）和呼吸困难（138 例，34.6%），而插入的症状则与部位有关。常见的并发症包括单纯食管黏膜损伤（105 例，26.3%）和气管食管瘘（93 例，23.3%），单纯鼻中隔穿孔（22 例，55.0%）和单纯黏膜损伤（13 例，32.5%）。吞食病例中有 2.5%发生肠穿孔，包括梅克尔憩室穿孔、腹膜炎和空肠结肠瘘。血管并发症在死亡患儿中很常见。年龄（≤2 岁）、电池暴露时间（>6 小时）和电池直径（≥20 毫米）与吞食的常见和严重并发症有关。
BB 损伤具有时间紧迫性，严重后遗症主要影响幼儿。诊断具有挑战性。需要通过监管和更安全的电池设计开展预防工作来消除这一问题。
