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1) (1417). Krom H, Elshout G, Hellingman CA, et al. Foreign bodies ingestion in children: experience of 61 cases in a, 8. NASPGHAN - About Us doi: 10.7759/cureus.31494. 2015 Apr; 60: (4): 562-74. Abdominal radiography revealed a foreign body in the left upper quadrant, which was the three circular magnets. | Find, read and cite all the research you . 0 comments. The clinical pathways are based upon publicly available medical evidence and/or a consensus of medical practitioners at The Childrens Hospital of Philadelphia (CHOP) and are current at the time of publication. Clarify type of object and timing of ingestion. We included randomized controlled trials, cohort studies, cross-sectional studies, clinical trials, epidemiological studies, systematic reviews, meta-analyses, and consensus statements/guidelines published in English up to May 2020. Turk J Pediatr. In this article, the ESPGHAN's view on these topics is discussed in more detail. Poison Control Center (PCC) 4-2100 or 800-222-1222 Copyright 2019 NASPGHAN | Privacy Policy | Website By: Opus Media. Food refusal, weight loss. Foreign-Body Ingestions of Young Children Treated in US Emergency 1994 .. ESPGHAN-NASPGHAN Guidelines for the Evaluation and Treatment of Gastrointestinal and . 3401 Civic Center Blvd. Waters AM, Teitelbaum DH, Thorne V, Bousvaros A, Noel RA, Beierle EA. Childrens Hospital of Philadelphia is a charitable 501(c)(3) nonprofit organization. 2015 Apr;60(4):562-74. doi: 10.1097/MPG.0000000000000729. Possible complications after battery ingestions are listed in Table 1. 2015 Nov;199(1):137-40. doi: 10.1016/j.jss.2015.04.007. Hoagland M, Ing R, Jatana K, et al. Pediatric Foreign Body Ingestion - Medscape In agreement with earlier guidelines, immediate localization of the BB is important and in case of esophageal impaction, the BB should be removed instantly (preferably <2 hours). Coins are the most commonly swallowed foreign body that comes to medical attention in the U.S.; in other countries, those related to food, such as fish bones, are most common. 38. Clinical Practice Guidelines : Foreign body ingestion Updates in pediatric gastrointestinal foreign bodies. J Korean Med Sci. The European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) is a multi-professional organisation whose aim is to promote the health of children with special attention to the gastrointestinal tract, liver and nutritional status, through knowledge creation, the dissemination of science based information, the promotion of best practice in the delivery of . Foreign body and caustic ingestions in children are usually the most common clinical challenges for emergency physicians, general pediatricians and pediatric gastroenterologists. [PDF] Management of ingested foreign bodies in children: a clinical Journal of Pediatric Gastroenterology and Nutrition - Volume 66, Number 1, January 2018. Bethesda, MD 20894, Web Policies Esophageal electrochemical burns due to button type lithium batteries in dogs. In case, a battery is lodged in the small intestine and causes symptoms or does not pass spontaneously, surgical evaluation and removal is necessary, which fortunately is rarely needed. 40. About Us. Foreign body ingestion is one of the common problems among children. 2023 Jan 2;38(1):e2. An algorithm for the diagnosis and management of BB ingestions is presented and compared to previous guidelines (NASPGHAN, National Poison Center). It is not a substitute for care by a trained medical provider. Background: Autism Spectrum Disorder (ASD) is a multifaceted neurodevelopmental condition characterized by multiple psychological and physiological impairments in young children. PDF Diagnosis,Management,andPreventionofButtonBattery Ingestion in According to the NASPGHAN guideline, removal is, therefore, advised if a BB is still in the stomach after 2 to 4 days (30). Keyword Highlighting The aim of this paper was to present foreign body and caustic ingestion in childhood in terms of epidemiology, pathophysiology, diagnostic work-up and appropriate management and potential complications in accordance with clinical presentation and the type of ingested substance/foreign body. In complicated cases, this period should be extended until the patient is stabilized. Foreign Body Ingestion Clinical Pathway Emergency Department, ICU J Surg Res. Therefore, based on this evidence, we recommend that once the BB has passed the esophagus, asymptomatic cases should be followed-up after 7 to 14 days with an X-ray to confirm passage unless the battery has been noticed in the stools by the parents (parents should be instructed to check all stools) (3,24). Button battery ingestion: a true surgical and anesthetic emergency. Moreover, presenting symptoms differ according to the impaction site (2,14,22). Paediatric Clinical Practice Guideline RACH Clinical Practice Guideline - Foreign body ingestion Page 3 of 5 Hazardous ingested foreign bodies Do not use metal detector for hazardous FB - the child will usually require x-rays Passage of hazardous FB into the stomach is NOT an indication that the child will not suffer any complications. Some error has occurred while processing your request. UL1 TR000077/TR/NCATS NIH HHS/United States, NCI CPTC Antibody Characterization Program. Finally, in otherwise healthy children (especially toddlers) with acute onset of hematemesis, a high index of suspicion for battery ingestion should be maintained and diagnostics should be performed to expose the battery. eCollection 2022. The https:// ensures that you are connecting to the 16. All patients with mucosal injury after battery removal should be admitted to the hospital and monitored closely. impaction, foreign body ingestion, magnet, superabsorbent (JPGN 2015;60: 562-574) I n 2000 the American Association of Poison Control Centers documented that 75% of the >116,000 ingestions reported were in children 5 years of age or younger (1). NASPGHAN Clinical Practice Guideline for the Diagnosis and Treatment of Nonalcoholic Fatty Liver Disease in Children: Recommendations from the Expert Committee on NAFLD (ECON) and the North American Society of Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN) Journal of Pediatric Gastroenterology and Nutrition - Volume 64, Number . oa - qscience.com Severe gastric damage caused by button battery ingestion in a 3-month-old infant. You may search for similar articles that contain these same keywords or you may Therefore, giving honey and/or sucralfate (1 g/10 mL suspension) might be considered within this time span. This leads to hydroxide ion formation at the negative pole, which in turn rapidly leads to pH rise causing tissue liquefaction and necrosis, comparable with damage occurring in the esophagus after alkaline liquid ingestion (1012). Esophageal battery impaction has the highest risk of complications, especially in children <6 years of age and in batteries >20 mm in diameter. As ESPGHAN task force for battery ingestions, we aim at contributing to all these factors, which are paramount for the prevention of BB ingestion. 33. Journal of Pediatric Gastroenterology and Nutrition - Volume 64, Number 6, June 2017. Basic mechanism of button battry ingestion injuries and novel mitigation strategies after diagnosis and removal. Such cases are considered highly emergent as mucosal damage can occur within 2 hours if the battery is impacted in the esophagus necessitating urgent endoscopic removal. Copyright 2019 NASPGHAN | Privacy Policy | Website By: Opus Media. Published by Elsevier Ltd. All rights reserved. Unable to load your collection due to an error, Unable to load your delegates due to an error. Note that MRI scans should never be performed before removal of a battery. It is important that the X-ray includes the entire neck, chest, and abdomen to avoid missing a BB. Diagnosis, Management, and Prevention of Button Battery Inge - LWW Eliason M, Melzer J, Winters J, et al. PDF Copyright ESPGHAN and NASPGHAN. All rights reserved. Established by the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN), Clinical Guidelines & Position Statements, Journal of Pediatric Gastroenterology and Nutrition - Volume 74, Issue S1, March 2022, Journal of Pediatric Gastroenterology and Nutrition - Volume 66, Issue 3, March 2018, Journal of Pediatric Gastroenterology and Nutrition - Volume 64, Number 6, June 2017, Journal of Pediatric Gastroenterology and Nutrition - Volume 64, Number 2, February 2017, Journal of Pediatric Gastroenterology and Nutrition - Volume 64, Number 1, January 2017, Journal of Pediatric Gastroenterology and Nutrition - Volume 63, Number 5, November 2016, Journal of Pediatric Gastroenterology and Nutrition - Volume 58, Number 2, February 2014, Journal of Pediatric Gastroenterology and Nutrition - Volume 56, Supplement 1, January 2013, Journal of Pediatric Gastroenterology and Nutrition - Volume 54, Number 6, June 2012, Journal of Pediatric Gastroenterology and Nutrition - Volume 40, Number 1, January 2005, (For primary care physicians/pediatricians), Journal of Pediatric Gastroenterology and Nutrition - Volume 76, Number 1, January 2023, Journal of Pediatric Gastroenterology and Nutrition - Volume 74, Number 5, May 2022, Journal of Pediatric Gastroenterology and Nutrition - Volume 74, Number 1, January 2022, Journal of Pediatric Gastroenterology and Nutrition - Volume 72, Number 3, March 2021, Journal of Pediatric Gastroenterology and Nutrition - Volume 72, Number 2, February 2021, Journal of Pediatric Gastroenterology and Nutrition - Volume 72, Number 1, January 2021, Journal of Pediatric Gastroenterology and Nutrition - Volume 71, Number 4, October 2020, Journal of Pediatric Gastroenterology and Nutrition - Volume 71, Number 3, September 2020, Journal of Pediatric Gastroenterology and Nutrition - Volume 71, Number 2, August 2020, Journal of Pediatric Gastroenterology and Nutrition - Volume 71, Number 1, July 2020, Journal of Pediatric Gastroenterology and Nutrition - Volume 70, Number 6, June 2020, Journal of Pediatric Gastroenterology and Nutrition - Volume 70, Number 5, May 2020, Journal of Pediatric Gastroenterology and Nutrition, Volume 70, Number 3, March 2020, Journal of Pediatric Gastroenterology and Nutrition, Volume 69, Number 4, October 2019. Department of Pediatric Gastroenterology, Erasmus Medical Center-Sophia Children's Hospital, Rotterdam, The Netherlands. 2017 Jun;64(3):507-524. doi: 10.1016/j.pcl.2017.01.004. Ruhl D, Cable B, Rieth K. Emergent treatment of button batteries in the oesophagus: evolution of management and need for close second look esophagoscopy. The North American Society for Pediatric Gastroenterology and Nutrition (NASPGHAN) requests qualified members of the Society to apply for the position of Editor-In-Chief, Western Hemisphere, for JPGN Reports for the period of January 1, 2023 to December 31, 2027. English Espaol Portugus Franais Italiano Svenska Deutsch Ing R, Hoagland M, Mayes L, et al. Clinical Guidelines & Position Statements; Continuing Education Resources. Litovitz T. Battery ingestions: product accessibility and clinical course. Foreign body ingestion in children: should button batteries in the stomach be urgently removed? Jatana K, Rhoades K, Milkovich, et al. DOI: 10.1097/MPG.0000000000000729 Corpus ID: 24259336; Management of ingested foreign bodies in children: a clinical report of the NASPGHAN Endoscopy Committee. This can be done with 50 to 150 mL 0.25% sterile acetic acid and should only be considered if signs of perforation are absent (21,3236). Preschoolers of both sexes, adolescent boys, and children with mental health issues are at the highest risk. When the foreign body has passed the esophagus, the majority of patients remain asymptomatic but a sensation of foreign body, with dysphagia, can persist for several hours and thus can mimic a persisting foreign body impaction. In approximately 10% of cases, the batteries were obtained from the packaging. Wolters Kluwer Health This PedsCases Note provides a one-page infographic on foreign body ingestion. 34. The mechanism of action is thought to be not only coating of the battery and thereby limiting electrolysis but also neutralization of generated hydroxide as both honey and sucralfate are weak acids. Please enable it to take advantage of the complete set of features! PG Course 2022 - NASPGHAN Philadelphia, PA 19104, Confirmed esophageal button battery Activate, Know My Rights About Surprise Medical Bills, Button Battery Ingestion Triage and Treatment Guideline, NBIH Button Battery Ingestion Triage and Treatment Guideline. Get new journal Tables of Contents sent right to your email inbox, https://www.duracell.com/en-us/press/duracell-debuts-breakthrough-child-safety-feature-lithium-coin-batteries/, https://www.productsafety.gov.au/system/files/National%20strategy%20for%20improving%20the%20safety%20of%20button%20battery%20consumer%20products.pdf, MPG_2021_01_06_RIDDER_JPGN-20-890_SDC1.docx; [Word] (2.19 MB), Diagnosis, Management, and Prevention of Button Battery Ingestion in Childhood: A European Society for Paediatric Gastroenterology Hepatology and Nutrition Position Paper, Articles in Google Scholar by Amani Mubarak, Other articles in this journal by Amani Mubarak, An ESPGHAN Position Paper on the Use of Breath Testing in Paediatric Gastroenterology, Characterization of Eosinophilic Esophagitis From the European Pediatric Eosinophilic Esophagitis Registry (pEEr) of ESPGHAN, European Society Paediatric Gastroenterology, Hepatology and Nutrition Guidelines for Diagnosing Coeliac Disease 2020, North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition Position Paper on the Diagnosis and Management of Pediatric Acute Liver Failure, Pediatric Gastroesophageal Reflux Clinical Practice Guidelines: Joint Recommendations of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition and the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition, Privacy Policy (Updated December 15, 2022), by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition, Aortoesophageal or other major arterial branch fistula, Button battery ingestions pose a huge health risk for the. Please try again soon. This is through raising public awareness and developing prevention strategies with the industry in the first place, and secondly by aiming for better diagnoses and treatment. Of all children worldwide presenting with foreign body ingestion, the percentage of children with battery ingestion is estimated to be as high as 7% to 25% (58). eCollection 2022 Nov. Xu G, Chen YC, Chen J, Jia DS, Wu ZB, Li L. BMC Emerg Med. Use of this site is subject to theTerms of Use. 13 The foreign body reaction at the site of impaction causes a local inflammatory response with bowel wall thickening. Kramer RE, Lerner DG, Lin T, Manfredi M, Shah M, Stephen TC, Gibbons TE, Pall H, Sahn B, McOmber M, Zacur G, Friedlander J, Quiros AJ, Fishman DS, Mamula P; North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition Endoscopy Committee. North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition Endoscopy Committee. No limitation in the search period was made. 8600 Rockville Pike Antoniou D, Christopoulos-Geroulanos G. Management of foreign body ingestion and food bolus impaction in children: a retrospective analysis of 675 cases. Most battery ingestions occur in children <6 years of age with a peak at 1 year of age, which is also the age with the highest risk of complications (1,3). Guidelines - European Society of Gastrointestinal Endoscopy (ESGE) Illustratively, according to the US National Poison Center, there were 3467 BB ingestions (10.46 per million) in that country alone in calendar year 2019 including 53% in children <6 years of age, 1.5% who experienced severe complications, and 3 who have died (21). According to the recent reports, 1 out of every 58 newly-born children is suffering from autism. Clipboard, Search History, and several other advanced features are temporarily unavailable. 2020 Nov;52(11):1266-1281. doi: 10.1016/j.dld.2020.07.016. This Guideline refers to infants, children and adolescents aged 0-18 years. British Society of Gastroenterology (BSG) and British Society of Paediatric Gastroenterology, Hepatology and Nutrition (BSPGHAN) joint consensus guidelines on the diagnosis and management of eosinophilic oesophagitis in children and adults. Therefore, battery ingestions should be considered an important hazard to the pediatric population. We are commemorating the occasion by highlighting the Society's history with a timeline detailing the seminal events that have made NASPGHAN into the organization it is today. NASPGHAN is celebrating its 50th anniversary in 2022. Your message has been successfully sent to your colleague. According to recent data, there was a 7-fold increase in the relative risk of severe morbidity because of BB ingestion in the last 2 decades (4). In asymptomatic cases with location of the battery in the stomach or in the small intestine or colon, patients can be followed up with X-ray 7 to 14 days after ingestion. Drterler M. Clinical profile and outcome of esophageal button battery ingestion in children: an 8-year retrospective case series. Journal of Pediatric Gastroenterology and Nutrition The aetiology of the disorder is complex and poorly understood, hindering the adaptation of targeted and effective . Exhaustive discharge instructions need to be provided outlining the signs and symptoms of upper gastro-intestinal bleeding. Keywords: M.T., C.T. An official website of the United States government. Foreign body and caustic ingestions in children are usually the most common clinical challenges for emergency physicians, general pediatricians and pediatric gastroenterologists. In fact, Lahmar et al (39) calculated that almost 70% of the ingestions can be prevented with screw-secured compartments and individual blisters for batteries. Diaconescu S, Gimiga N, Sarbu I, et al. naspghan foreign body guidelines naspghan foreign body guidelines Presence of a BB in the esophagus is considered to be a medical emergency and endoscopic removal is necessary as soon as possible (<2 hours). Foreign Body and Caustic Substance Ingestion in Childhood Paediatric Gastrointestinal Endoscopy: European Society for - LWW . Esophageal lesions following button-battery ingestion in children: analysis of causes and proposals for preventive measures. naspghan foreign body guidelines cardboard knife sheath 2. Logically, voltage and duration of the impaction are associated with more rapid and severe injury, although it is important to realize that even used or old batteries can retain sufficient residual voltage to cause tissue damage. Foreign body ingestion in pediatric patients. 26. Highlight selected keywords in the article text. 8:00 AM Foreign Body Ingestions. What Is New Figure 2 shows the diagnostic and management algorithm for battery ingestions and is discussed below. See Button Batteries, Convenience at a Cost by Barker on page 2. Additionally, raising public awareness making parents and caregivers aware of the dangers of battery ingestion is essential as this could increase their cautiousness with products containing batteries and seek early medical attention when an ingestion has occurred. ESPGHAN Guidelines . Clinical Presentation and Outcome of Multiple Rare Earth Magnet A separate court decision later vacated the CPSCrecall order. In the respiratory tract, complications in the nasal cavity are the most common and account for almost 16% of the complications (3). Moderators: Javier Monagas, MD, Baylor College of Medicine and Maria Oliva-Hemker, MD, Hopkins University School of Medicine. According to the CPSC's own estimates, thousands of otherwise preventable injuries have occurred in children due to these high-powered magnet sets. Unfortunately, severe damage can occur within 2 hours after becoming lodged in the tissue (1,2). Yoshikawa T, Asai S, Takekawa Y. Depending on the severity of the injury, this may be considered to be continued up to for 4 weeks in order to avoid mechanical injury. Although adults most often present to the ED because of health problems related to ingestion of radiolucent foreign bodies (typically food), children usually swallow radiopaque objects, such as coins, pins, screws, button batteries, or toy parts.Although children commonly aspirate food items, it is less common for small children to present because of foreign body complications due to food . Supplemental digital content is available for this article. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). The Association of Pediatric Gastroenterology and Nutrition Nurses, Help & Hope for Children with Digestive Disorders, Journal of Pediatric Gastroenterology and Nutrition, Digestive Health for Life Partners Program, Conflict of Interest, Ethics, and Policy Statements, Council for Pediatric Nutrition Professionals, Clinical Guidelines & Position Statements, COVID-19 Resources for Healthcare Providers, 2023 Medical Student Mentored Summer Research Program, NASPGHAN Celebrates Tanisha Richards, N.P. Search for Similar Articles In case of severe mucosal injury, delayed diagnosis or severe symptoms indicative of complications (such as bleeding), the (cardiothoracic) surgeon should be consulted and further imaging (CT-scan) should be performed even before the removal, as moving the battery might lead to acute perforation or hemorrhage through a fistula. The battery gets stuck in the esophagus where after both poles are in close contact with the mucosa. Epub 2022 Jul 11. Lead Poisoning from a Toy Necklace, Study Authors Advise Giving Honey to Children who Swallow Button Batteries, Esophageal, nasal or airway Button Battery, Cluster notification to ENT, GI, Gen Surgery and OR to prepare for patient, Sharp longer objects in stomach with no symptoms, 2022 The Childrens Hospital of Philadelphia. Finally, prevention strategies are discussed in this paper. For example, 80-90% of ingested foreign bodies are able to pass without intervention, 10-20% must be removed endoscopically, and only approximately 1% require surgery [].However, intentional ingestion results in intervention rates as high as 76% [], and surgical intervention is performed in as many as 28% . In such cases, early and frequent ingestion of honey, and if available, sucralfate in the clinical setting may have the potential to reduce injury severity and improve patient outcomes (31). Established by the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN). Patients can even present with an acute hemorrhage (2,14,22). National Battery Ingestion Hotline 800-498-8666. Diagnostic algorithm for button battery ingestions. Qatar Med J. 25. Soto P, Reid N, Litovitz T. Time to perforation for button batteries lodged in the esophagus. sharing sensitive information, make sure youre on a federal 10. PDF | Introduction: Rare earth magnets are powerful magnets that can have several negative effects if ingested. Keywords: foreign body ingestion, caustic ingestion . Batteries in the esophagus are typically the most problematic, probably because of the alkaline environment and increased risk of lodgement of foreign bodies in the esophagus, compared with the rest of the gastrointestinal tract. Early dilatation of a stricture will lead to better swallowing function; however, one should wait 4 weeks postingestion for the tissue to be healed (2). Umay E, Eyigor S, Giray E, Karadag Saygi E, Karadag B, Durmus Kocaaslan N, Yuksel D, Demir AM, Tutar E, Tikiz C, Gurcay E, Unlu Z, Celik P, Unlu Akyuz E, Mengu G, Bengisu S, Alicura S, Unver N, Yekteusaklari N, Uz C, Cikili Uytun M, Bagcier F, Tarihci E, Akaltun MS, Ayranci Sucakli I, Cankurtaran D, Aykn Z, Aydn R, Nazli F. World J Pediatr. Before Direct URL citations appear in the printed text, and links to the digital files are provided in the HTML text of this article on the journal's Web site (www.jpgn.org). As described above, (serial) MRI and CT scans are necessary to detect complications in patients with significant injury and/or delayed removal. Pediatr Gastroenterol Hepatol Nutr. If a battery and magnet have already passed the stomach, consultation of a surgeon is necessary; the patient should be either monitored closely or the battery and magnet should be removed surgically. Honda S, Shinkai M, Usui Y, et al. endstream endobj startxref Identifying predictive factors for long-term complications following button battery impactions: a case series and literature review. The advised dose for both is 10 mL (2 teaspoons) every 10 minutes with a maximum of 6 doses of honey and 3 doses of sucralfate, respectively (21,31). eCollection 2023. Gastrointest Endosc Clin N Am. Differently from the other published guidelines, the proposed one focuses on the role of the endoscopists (regardless of whether they are adult or pediatric gastroenterologists) in the diagnostic process of children with foreign body and caustic ingestions. Accessibility 7. Unauthorized use of these marks is strictly prohibited. The opposite is the case in adolescents and adults, in whom ingestion often is deliberate and related to . 31. It is, however, important to realize that available data are based on promising in-vitro and in-vivo studies of piglets while human studies are still lacking. Particular emphasis is on development and its relation to infant and . Accordingly, these clinical pathways are not intended to constitute medical advice or treatment, or to create a doctor-patient relationship between/among The Childrens Hospital of Philadelphia (CHOP), its physicians and the individual patients in question. Even infants may swallow foreign bodies that are given to them . Less is known about European ingestions but these have been described in case reports and series (9,14). If the ingested battery is located in the airway or in the gastrointestinal tract above the clavicles, an Ear, Nose and Throat (ENT) doctor should be consulted to remove objects from the (upper) airways or upper part of the esophagus by rigid endoscopy (16). This guideline refers to infants, children, and adolescents ages 0 to 18 years. Button battery; Caustic ingestions; Food impaction; Foreign body ingestion; Magnet. It causes serious morbidity in less than one percent of all patients, and . ESGPHAN DISCLAIMER: ESPGHAN is not responsible for the practices of physicians and provides guidelines and position papers as indicators. Disclaimer. Journal of Pediatric Gastroenterology and Nutrition - Volume 63, Number 1, July 2016. By having such a task force in Europe, we will be able to do so more effectively as we will be able to use a more localized approach. The areas covered include indications for diagnostic and therapeutic esophagogastroduodenoscopy and ileocolonoscopy; endoscopy for foreign body ingestion; corrosive ingestion and stricture/stenosis endoscopic management; upper and lower gastrointestinal bleeding; endoscopic retrograde cholangiopancreatography; and . Button batteries (BB) remain a health hazard to children as ingestion might lead to life-threatening complications, especially if the battery is impacted in the esophagus. Journal of Pediatric Gastroenterology and Nutrition - Volume 54, Number 2, February 2012, Journal of Pediatric Gastroenterology and Nutrition - Volume 53, Number 1, July 2011, Journal of Pediatric Gastroenterology and Nutrition - Volume 54, Number 1, January 2011, Journal of Pediatric Gastroenterology and Nutrition - Volume 47, Number 5, November 2008, Journal of Pediatric Gastroenterology and Nutrition - Volume 47, Number 3, September 2008, Journal of Pediatric Gastroenterology and Nutrition - Volume 44, Number 5, May 2007, Journal of Pediatric Gastroenterology and Nutrition - Volume 43, Number 4, October 2006, Journal of Pediatric Gastroenterology and Nutrition - Volume 43, Number 1, July 2006, Journal of Pediatric Gastroenterology and Nutrition - Volume 40, Number 4, April 2005, Journal of Pediatric Gastroenterology and Nutrition - Volume 40, Number 3, March 2005, The Association of Pediatric Gastroenterology and Nutrition Nurses, Help & Hope for Children with Digestive Disorders, Journal of Pediatric Gastroenterology and Nutrition, Digestive Health for Life Partners Program, Conflict of Interest, Ethics, and Policy Statements, Council for Pediatric Nutrition Professionals, COVID-19 Resources for Healthcare Providers.
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