Ingested button cell

Received an X-ray with a swallowed foreign body today. From the X-ray on the right, it is ingested foreign body is obviously demonstrable. It is situated in the region of the distal stomach or in the duodenum by virtue of its location on X-ray.

Close up view of the metallic foreign object reveals a thin lucent inner rim (picture on the left). These findings are in keeping with an ingested button cell battery.

The danger of swallowed button cells is when the batteries are lodged in the esophagus. A fully charged cell can leak and cause tissue burns and damage the mucosal coating.

It is thus, safer to have swallowed a used battery than a brand new one. The electric potential of the battery matters as well. A 1.5V battery is potentially less toxic than a 3.0V. A lithium battery is also obviously safer than a mercury battery, fortunately the latter is rare nowadays.

Most swallowed button cells are passed out within a week (even only after 2 days) but may take as long as few weeks. For radiographic follow up, if the cell is within the stomach, a daily abdominal X-ray is recommended. Once it has passed the pylorus, follow up X-ray in four day intervals should be done. Apart from its location, another finding worth watching out for is the disassembly of the cell. however, as stated before, unless it is a mercury cell, the risk of toxicity is rare even if the cell has fallen apart.

Finally, parents must be advised that the thin shaped button cells actually fascilitate the passage through the gastrointestinal tract. General measures like laxatives or adequate fluid should be encouraged. In most cases, spontaneous passage can be expected. Parents should also inspect the stools to confirm successful passage of the cell.