Plain films in the evaluation of batteries as esophageal foreign bodies (original) (raw)

Battery-induced Esophageal Foreign Body Injury, Complications and Treatment Outcome

West Indian Medical Journal, 2016

Objective: We aimed to assess the severity caused by button batteries in esophagus. Methods: Thirty two patients admitted with ingesting button batteries were retrospectively evaluated. Chest x-ray was ordered for diagnosis. Hospital stays, interventions , complications and mortality of the patients were collected. The time between the patients ingested the buton battery and its removal was defined as its duration in esophagus. All the patients underwent rigid esophagoscopy under general anasthesia. Buton batteries at the first narrowing were removed by magyl clamp. Results: 21 of 32 patients were female, with a mean age of 22 months. The mean duration of ingestion was 17 hours. The mean hospital stay was 10 days. Of the patients, 75% were admitted within 24 hours. Complication rate was 19% and mortality rate was 6%. There was a strong correlation among the number of the cases and the coming years (p<0.001). Linear regression test was used in the number of cases and the duration ...

Disk Batteries in the Esophagus of Nigerian Children: Case Series

Otolaryngology online journal, 2015

Foreign body (FB) ingestion is common in clinical practice especially in children. Its impaction in the esophagus constitutes an important cause of morbidity and mortality in our environment. Due to technological advancement and increase use of disk batteries to power children toys and remote control gadgets, ingestion of disk batteries is now commonplace. In our environment there is paucity of information on disk batteries hence we decided to present case series of disk batteries in the esophagus of children highlighting the peculiarities of disk batteries, the dangers posed by them, the mode of retrieval, complications encountered, and possible recommendations to curtail the increasing occurrence.

Severe esophageal damage due to button battery ingestion: can it be prevented?

Pediatric Surgery International, 2004

Batteries represent less than 2% of foreign bodies ingested by children, but in the last 2 decades, the frequency has continuously increased. Most ingestions have an uneventful course, but those that lodge in the esophagus can lead to serious complications and even death. Medline was used to search the English medical literature, combining ''button battery'' and ''esophageal burn'' as keywords. Cases were studied for type, size, and source of the batteries; duration and location of the battery impaction in the esophagus; symptoms; damage caused by the battery; and outcome. Nineteen cases of esophageal damage have been reported since 1979.Batteries less than 15 mm in diameter almost never lodged in the esophagus. Only 3% of button batteries were larger than 20 mm but were responsible for the severe esophageal injuries in this series. These data suggest that manufacturers should replace large batteries with smaller ones and thus eliminate most of the complications. When the battery remains in the esophagus, endoscopic examination and removal done urgently will allow assessment of the esophageal damage, and treatment can be tailored accordingly. There is a need for more public education about the dangers of battery ingestion; this information should be included as part of the routine guidelines for childproofing the home.

Pathophysiology of esophageal impairment due to button battery ingestion

International Journal of Pediatric Otorhinolaryngology, 2017

Background: The increased use of button batteries with high energy densities in devices of daily life presents a high risk of injury, especially for toddlers and young children. If an accidental ingestion of a button battery occurs, this foreign body can become caught in the constrictions of the esophagus and cause serious damage to the adjacent tissue layers. The consequences can be ulcerations, perforations with fistula formation and damage to the surrounding anatomical structures. In order to gain a better understanding of the pathophysiology after ingestion, we carried out systematic studies on fresh preparations of porcine esophagi. Methods: The lithium button battery type CR2032, used most frequently in daily life, was exposed in preparations of porcine esophagi and incubated under the addition of artificial saliva at 37 C. A total of eight esophagi were analysed by different methods. Measurements of the pH value around the battery electrodes and histological studies of the tissue damage were carried out after 0.5e24 h exposure time. In addition, macroscopic time-lapse images were recorded. Measurements of the battery voltage and the course of the electric current supplemented the experiments. Findings: The investigations showed that the batteries caused an electrolysis reaction in the moist environment. The positive electrode formed an acidic and the negative electrode a basic medium. Consequently, a coagulation necrosis at the positive pole, and a deep colliquation necrosis at the minus pole occurred. After an exposure time of 12 h, tissue damage caused by the lye corrosion was observed on the side of the negative electrode up to the lamina muscularis. The corrosion progressed up to the final exposure time of 24 h, but the batteries still had sufficient residual voltage, such that further advancing damage would be expected. Conclusions: Button battery ingestion in humans poses an acute life-threatening danger and immediate endoscopic removal of the foreign body is essential. After only 2 h exposure time, significant damage to the tissue could be detected, which progressed continuously to complete esophageal perforation. The primary prevention of battery ingestion is therefore of particular importance.

Effect of fully charged and discharged batteries on esophageal tissue: an experimental study

2016

The aim of this study was to compare the effect of charged and discharged alkaline batteries on esopha-geal tissue, and to determine the impact of duration due to the exposure to alkaline batteries. Thirty-five rabbits were divided into 5 groups each containing 7 rabbits. Alkaline batteries were ingested by rabbits [except for the control group [Group 1]]. Rabbits in Group 2 were exposed to discharged alkaline batteries for 180 minutes. In Group 3-5, the fully charged batteries were left in esophagus for 60, 120, and 180 minutes, respectively. Macroscopic appearance of esophageal mucosa as well as histopathologic examination of battery induced esophageal injury and pH of environment were compared. Battery capsules were intact in each group. No color change was observed in the anode pole of batteries for Group 2. Color change was evident in the anode pole of batteries for 3 rabbits in Group 3, in 4 rabbits in Group 4, and in 7 rabbits from Group 5; while no significant change was obs...

Neglected esophageal button battery ingestion: Local protocol for management

Egyptian Journal of Ear, Nose, Throat and Allied Sciences, 2013

Button battery ingestion is a hazardous condition which is associated with the increasing technology in household products and using button battery for power supply. Most of the button battery ingestions are unwitnessed so parents' unawareness of the potential lethal outcomes may delay the doctor visit. Lack of a clear approach or strategy for diagnosis and treatment in the first line medical caregivers is the major concern. The current study presents two cases with neglected button battery ingestion referred to the emergency ward of Pediatrics Hospital of Tabriz. With regard to review of articles and authors' experiences a management protocol to early diagnosis is outlined for any suspected patients while the proper treatments to decline the life threatening complications are suggested which are simple to do for local practitioners.

Imaging button battery ingestions and insertions in children: a 15-year single-center review

Pediatric Radiology, 2016

Background Recent studies have shown an increase in morbidity associated with button battery ingestions in children. Objective To perform a comprehensive, imaging-focused review of all patients with confirmed button battery ingestions/ insertions imaged at our institution in the last 15 years. Materials and methods Radiology reports from Jan. 1, 2000, to July 12, 2015, were searched for the terms "battery" and "batteries." Confirmed cases of battery ingestion/insertion for which images were available were reviewed. Cases were reviewed for imaging studies performed, imaging findings, patient demographics, clinical history and management. Two pediatric gastroenterologists reviewed endoscopic images and graded mucosal injuries in selected cases. Results Two hundred seventy-six cases were reviewed. All patients were imaged with radiography, 19 with fluoroscopy (6.8%), and 4 with CT (1.4%). Batteries retained in the esophagus (n = 27, 9.8%) were larger in diameter on average than those that had passed distally (22.1 ± 3.3 mm vs. 13.7 ± 1.6 mm, P<0.0001). Battery diameter ≥20 mm was associated with esophageal impaction (P<0.0001) and higher grade esophageal injury (P<0.0001). Mean battery diameter was greater for patients with grade 1 or higher mucosal injury than for patients with no mucosal injury (22.1 ± 2.1 mm vs. 14.7 ± 4.5 mm, P<0.0001). Sixteen percent (4/25) of patients with grade ≥1 esophageal injury had batteries in the stomach on initial imaging. Five patients (1.8%) had serious clinical complications (e.g., esophageal perforation, tracheoesophageal fistula). Conclusion Button batteries >20mm in diameter warrant increased clinical scrutiny due to higher likelihood and severity of injury. Implementation of recent pediatric gastroenterology societal guidelines will likely lead to a substantial increase in the number of CT and MRI examinations.