CONTEXT Children presenting to health care facilities with button battery (BB) impaction. OBJECTIVES To describe characteristics of children with vascular complications after BB impaction, as well as associated outcomes. DATA SOURCES National Capital Poison Center registry and PubMed database from inception to December 2021. STUDY SELECTION All reports describing children aged <18 years with vascular, esophageal, or airway complications after BB ingestion. DATA EXTRACTION We extracted characteristics including date of publication, age and sex of child, battery type and size, duration and location of impaction, complications, subsequent interventions, and interval between battery removal and death. RESULTS A total of 361 cases involved severe complications or death after BB ingestion (321 cases from the National Capital Poison Center registry database, 40 additional cases from PubMed). Nineteen percent (69 of 361) were fatal and 14% (51 of 361) involved vascular injuries. Three-quarters (75%) of vascular complications were aorto-esophageal fistulae and 82% of vascular injuries were not survivable. Fatal vascular cases had significantly longer median impaction time (96 hours versus 144 hours, P <.05) and a wider range of presenting features than survivors. LIMITATIONS The total number of cases with vascular complications was small, data reported varied between cases, and no data were available on overall exposure. Long-term morbidity data were not available for the survivors. CONCLUSIONS Prolonged BB impaction is a risk factor for vascular complications and death. A high index of suspicion is required for children representing with hematemesis after BB impaction, with prompt transfer to a tertiary center because vascular surgical intervention may offer a chance of survival.

中文翻译：

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纽扣电池摄入后儿童的血管并发症：系统评价。

背景 因纽扣电池 (BB) 嵌塞而到医疗机构就诊的儿童。目的 描述 BB 嵌塞后发生血管并发症的儿童的特征以及相关结果。数据来源 National Capital Poison Center Registry 和 PubMed 数据库，从成立到 2021 年 12 月。研究选择所有报告描述了 18 岁以下儿童在摄入 BB 后出现血管、食道或气道并发症。数据提取 我们提取的特征包括出版日期、儿童的年龄和性别、电池类型和大小、撞击的持续时间和位置、并发症、后续干预措施以及电池移除和死亡之间的间隔。结果 共有 361 例涉及 BB 摄入后的严重并发症或死亡（321 例来自国家首都毒物中心登记数据库，另外 40 例来自 PubMed）。19%（361 人中的 69 人）是致命的，14%（361 人中的 51 人）涉及血管损伤。四分之三 (75%) 的血管并发症是主动脉食管瘘，82% 的血管损伤无法存活。与幸存者相比，致命性血管病例的中位嵌塞时间显着延长（96 小时对 144 小时，P <.05），表现特征范围更广。局限性血管并发症的病例总数很少，报告的数据因病例而异，并且没有关于总体暴露的数据。没有幸存者的长期发病率数据。结论 长期 BB 嵌塞是血管并发症和死亡的危险因素。对于 BB 嵌塞后出现呕血的儿童，需要高度怀疑，并及时转移到三级中心，因为血管外科手术可能提供生存机会。