Gastric Mucosal Damage From Ingestion of 3 Button Cell Batteries

Abstract

Management of ingested button batteries, according to recently updated recommendations from the National Capital Poison Center, is based primarily on symptoms and where the batteries lodge. Batteries in the esophagus can cause life-threatening or even fatal complications including esophageal perforation (1,2), tracheo-esophageal fistulas (3,4), and hemorrhage from arterial fistulization (8). Injury is thought secondary to electrochemical burns from electrical discharge. Chemical burns from electrolyte alkali leakage and pressure necrosis also may contribute (5). Early endoscopic removal from the esophagus is thus advocated. In contrast, management when button batteries have passed the lower esophageal sphincter is less clear. Few cases of injury have been reported from button batteries distal to the esophagus (6,7). Indications for removal are not fully delineated. We report a case in which 3 ingested button batteries were removed from a young child’s stomach. Significant mucosal injury was found in the gastric body despite early intervention. Further information is needed to determine the clinical conditions under which button batteries lodged in the stomach warrant early extraction.