see also: Lye Ingestion
Disc batteries can cause significant morbidity in a short period of time in the pediatric population. Approximately 60% of disc battery ingestions occur after removal from a device. This creates an emergent situation as esophageal perforation has been reported in at little as 5 hours. Injury occurs secondary to liquefactive necrosis, pressure necrosis and electrical charge.
Batteries that are 1.5 to 2 cm of size are much more likely to become lodged at the level of the cricopharyngeus muscle.
Imaging confirming location should be obtained prior to EMERGENT transfer to the OR for removal. The Double Lumen sign confirms the presence of a disc battery.
Click on the images below to enlarge, advance to next with cursor over right mid border
XRAY confirmation of the "Double Lumen" sign
Initial injury is managed in the OR. This patient was placed into suspension with a Lindholm Laryngoscopy with removal under direct visualization with the aid of a Bruce Benjamin laryngeal lift maneuver. It is important to identify the direction of the negative pole of the battery for future assessment of this injury.
Photos of Alkalinic Esophageal Injury
Esophagoscopy is performed at 24-48 hours after injury to evaluate the full extent of injury. If perforation of esophagus is identified, the procedure is aborted. The local injury was approximate 3 cm in size with 5 cm of inferior extension into the esophagus. A normal introitus is identified proximally.
Esophagoscopy at 24 to 48 hours
A CR2032 disc battery is dropped into saline with continued, and immediate activity. Photos were obtained every 15 minutes for the first two hours, and every thirty minutes for a total of five hours, demonstrating activity from the negative pole during the entire time course.
Disc Battery Activity in Saline
Handout demonstrating disc battery activity:
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