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Routine guidelines for the management of button battery ingestion recommend no oral intake before timely radiographic localization and emergency endoscopic removal of esophageal button batteries.

A recent study using in vitro and in vivo animal models of esophageal battery impaction suggested that early and repeated oral administration of either honey or sucralfate until the battery is removed may reduce the severity of esophageal burns.

The study** included asymptomatic children with acute button battery ingestions (eg, witnessed or likely to have occurred within one to two hours) and who are older than one year of age, have no allergies to honey or its components.

It has been, suggested that one oral dose of pure honey (eg, 5 to 10 mL) be given as soon as possible after ingestion. And once in the emergency department, the child may receive another dose of honey or a single dose of sucralfate 500 mg prior to confirmation of esophageal impaction and emergency battery removal.

Although this approach runs counter to the usual approach of no oral intake until operative removal, the benefit of neutralization and reduction in burn injury to the esophagus appears to outweigh the potential increased risk of aspiration.

Laryngoscope. 2019 Jan;129(1):49-57. doi: 10.1002/lary.27312. Epub 2018 Jun 11.

pH-neutralizing esophageal irrigations as a novel mitigation strategy for button battery injury.

Anfang RR1, Jatana KR2, Linn RL3, Rhoades K4, Fry J4, Jacobs IN1,5.

  1. Division of Otolaryngology, Department of Surgery, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
  2. Department of Otolaryngology-Head and Neck Surgery, Nationwide Children's Hospital and Wexner Medical Center at Ohio State University, Columbus, Ohio
  3. Division of Anatomic Pathology, Department of Pathology and Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
  4. Intertek Product Intelligence Group Inc, Oakbrook, Illinois.
  5. Department of Otorhinolaryngology-Head and Neck Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, U.S.A.

Posted On: 13/05/2019

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