Batteries, Disk-Shaped (Ingestion/Poisoning)

Key Features

• Small, flat, smooth disk-shaped batteries measure between 10 and 25 mm in diameter

• About 69% of them pass through the gastrointestinal (GI) tract in 48 hours and 85% in 72 hours

• Some may become entrapped and lead to caustic injury

Clinical Findings

• Batteries impacted in the esophagus may cause symptoms of refusal to take food, increased salivation, vomiting with or without blood, and pain or discomfort

• Aspiration into the trachea may also occur

• Fatalities have been reported in association with esophageal perforation or fistula formation

Diagnosis

• When a history of disk battery ingestion is obtained, radiographs of the entire respiratory tract and GI tract should be taken immediately so that the battery can be located and the proper therapy determined

Treatment

• If the disk battery is located in the esophagus, it must be removed immediately

• Any prolonged time in the esophagus can cause injury

• Consultation with GI or surgical subspecialty is recommended

• Asymptomatic patients may simply be observed and stools examined for passage of the battery

• If the battery has not passed within 7 days or if the patient becomes symptomatic, radiographs should be repeated

• If the battery has come apart or appears not to be moving, a purgative, enema, or nonabsorbable intestinal lavage solution should be administered

• If these methods are unsuccessful, surgical intervention may be required

• Levels of heavy metals (mainly mercury) should be measured in patients in whom the battery has opened or symptoms have developed