Disk Battery Ingestion

What is Disk Battery Ingestion?

Disk batteries, also known as button batteries, are commonly found in numerous everyday electronic items. Over recent years, the growing popularity of compact electronic products has led to an increased use of these kinds of batteries, which in turn has resulted in higher cases of people accidentally swallowing them.

Button batteries can cause serious harm if they are inhaled or swallowed, with most of these incidents happening among small children. However, the positive news is that most intake of disk batteries turn out to be harmless. Although complications are unusual, they can indeed be severe and can potentially result in damage to the esophagus, trachea, laryngeal nerve, or related structures.

It’s also worth noting that more than 97% of button battery swallowing cases usually have mild or no effects at all.

What Causes Disk Battery Ingestion?

Harm can take place if batteries are swallowed or breathed in. Thankfully, most batteries move through the digestive system without causing any trouble. However, problems can arise when disc-shaped batteries get stuck in parts of the body like the throat, the windpipe, the food pipe, or elsewhere in the digestive system. This can cause local damage, ulcers, holes, or an abnormal connection between body parts.

This harm can happen quickly, but often appears gradually over time. What’s more, the effects of this kind of injury can continue to happen, even many days or weeks after the initial event and treatment.

Risk Factors and Frequency for Disk Battery Ingestion

Between 1985 and 2009, there were 56,535 reported cases of people swallowing button batteries, according to the National Poison Data System. Most of these incidents, 68.1%, involved children under six, while 20.3% concerned children aged between 6 and 19. Every year, American Poison Control Centers receive reports of over 3,300 such incidents.

Most cases involve children under six, particularly those aged between one and three years.
Most of the time, nobody sees the child swallowing the battery.
More than half of these incidents happen within 30 minutes of the battery being removed from the device.
A second peak of incidents involves elderly patients, with 10% of cases occurring in those aged 60 to 89 years old. These patients are more often found with disk batteries stuck in their small or large bowels.
Slightly more boys than girls swallow disk batteries.

In the past decade, there has been a near seven-fold increase in serious health problems and deaths related to swallowing button batteries. This increase is not due to more people swallowing batteries but is likely due to the use of larger and more powerful batteries.

Signs and Symptoms of Disk Battery Ingestion

Swallowing a disc battery can lead to various symptoms based on when it was swallowed, the battery type, and where it’s located in the body. Surprisingly, most people who swallow a button battery don’t experience any symptoms. If symptoms do occur, they’re usually quite common, such as feeling sick, vomiting, difficulty swallowing, being irritable, and having abdominal pain. These symptoms occur in only about 10 – 20% of patients. If the battery ends up in the nasal cavity, it can cause a bloody nasal discharge.

More serious injuries tend to occur if the swallowing of the battery isn’t noticed straight away. This can lead to the battery causing tissue damage and holes (perforation). Potential complications from this can include pneumonia, the formation of abnormal connections between different body parts (fistula), inflammation of the chest cavity (mediastinitis), a collapsed lung (pneumothorax), intestinal perforation, inflammation of the abdominal cavity (peritonitis), inflammation of the bone (osteomyelitis), injury to the nerve that supplies the voice box, and paralysis of the vocal cords.

These serious symptoms can develop hours to days after swallowing the battery and can include:

Chest pain
Noisy and difficulty breathing (stridor)
Dark sticky poo (melena)
Bloody stools
Vomiting blood (hematemesis)
Husky voice (hoarseness)
Coughing
Abdominal pain
Fever

It’s important to get a history from someone who has swallowed a battery. Essential details would include the type of battery, when it last changed (new batteries can cause more tissue damage), the time they swallowed it, and the potential number of batteries swallowed.

Physical symptoms of acute disc battery swallowing aren’t specific. If a battery is in the nasal cavity, you might be able to see it directly. Findings in patients who have batteries in the esophagus or lower down are usually unremarkable. If the patient is seen later, the symptoms can vary widely depending on the location of the injury.

Testing for Disk Battery Ingestion

If doctors suspect that a person may have swallowed a button battery, they will typically order straightforward X-ray images. These images will cover the head, neck, chest, and abdomen from both a front-to-back (anteroposterior) and side view (lateral). Button batteries have a unique look on these X-rays, showing a “step-off” on the side view and a “double-density” or halo sign on the front-to-back view.

However, it’s important to be careful when making a diagnosis, as disc batteries can often look like coins in these images. To make an accurate diagnosis, doctors might order additional X-rays taken from different angles.

Treatment Options for Disk Battery Ingestion

If someone swallows a button battery, initial actions should involve checking the person’s age, the battery’s type and size, when it was swallowed, and where it is now inside the body. People who don’t have any symptoms and the battery has moved past the esophagus don’t typically have a high risk of serious health problems. The current guidelines from the National Battery Ingestion Hotline and Button Battery Taskforce suggest just keeping a close eye on these patients and taking follow-up X-rays after about 10 to 14 days.

However, for higher-risk patients (children under six years old or those who have swallowed batteries that are larger than 15 millimeters), they should have another X-ray in 4 days. If the battery hasn’t moved beyond the stomach by then, doctors recommend that it be removed endoscopically. For some high-risk patients, such as children under five years old or those who have swallowed batteries larger than 20 millimeters, there’s concern about potential damage to the esophagus as the battery moves into the stomach. So, doctors may consider doing an endoscopy early on.

For all other situations, immediate endoscopic removal of the battery is advised. The location where this procedure takes place is important, especially if there’s a risk of bleeding or it may not be possible to remove the battery using an endoscope. High-risk cases may be best handled in a heart cath lab or a general operating room, which have better imaging technology and the possibility of switching to open surgery if necessary. Due to the high chance of severe injury, even in a short amount of time, cases of swallowed button batteries should be given high priority. Special care should be taken to coordinate with medical and surgical specialists as needed for each individual case. It’s also important to note that patients should not eat or drink anything, and their airways should be protected.

The specifics of how the battery will be removed depend on where it’s located in relation to the major blood vessels, such as the aorta. If it’s suspected that a blood vessel might be involved, an angiography may be considered. An endoscopy might be done after removing the battery to assess the extent of any injuries or potential complications.

The process of diagnosing this is usually simple. However, it’s possible to mistake disc batteries for a coin or a heart monitor wire when looking at basic x-ray images.

Frequently asked questions

Disk battery ingestion refers to the act of accidentally swallowing a disk battery, which can cause serious harm if inhaled or swallowed. Most cases of disk battery ingestion occur among small children, but the majority of these incidents have mild or no effects. However, complications can be severe and potentially damage the esophagus, trachea, laryngeal nerve, or related structures.

Between 1985 and 2009, there were 56,535 reported cases of people swallowing button batteries, according to the National Poison Data System.

Signs and symptoms of disc battery ingestion can vary depending on factors such as when it was swallowed, the type of battery, and its location in the body. However, most people who swallow a button battery do not experience any symptoms. If symptoms do occur, they are usually common and may include: - Feeling sick - Vomiting - Difficulty swallowing - Irritability - Abdominal pain These symptoms occur in only about 10 - 20% of patients. If the battery ends up in the nasal cavity, it can cause a bloody nasal discharge. More serious injuries can occur if the battery is not noticed immediately. This can lead to tissue damage and perforation, which can result in complications such as: - Pneumonia - Fistula (abnormal connections between body parts) - Mediastinitis (inflammation of the chest cavity) - Pneumothorax (collapsed lung) - Intestinal perforation - Peritonitis (inflammation of the abdominal cavity) - Osteomyelitis (inflammation of the bone) - Injury to the nerve that supplies the voice box - Paralysis of the vocal cords These serious symptoms can develop hours to days after swallowing the battery and may include: - Chest pain - Noisy and difficulty breathing (stridor) - Dark sticky poo (melena) - Bloody stools - Vomiting blood (hematemesis) - Husky voice (hoarseness) - Coughing - Abdominal pain - Fever To properly assess a case of battery ingestion, it is important to obtain a thorough history, including details such as the type of battery, when it was last changed, the time of ingestion, and the potential number of batteries swallowed. Physical symptoms of acute disc battery swallowing are not specific. In some cases, a battery in the nasal cavity may be visible, but findings in patients with batteries in the esophagus or lower down are usually unremarkable. If the patient is seen later, the symptoms can vary widely depending on the location of the injury.

Disk Battery Ingestion can occur when disc-shaped batteries get stuck in parts of the body like the throat, the windpipe, the food pipe, or elsewhere in the digestive system.

A doctor needs to rule out the conditions of a coin or a heart monitor wire when diagnosing Disk Battery Ingestion.

The types of tests needed for disk battery ingestion include: - X-ray images: These images will cover the head, neck, chest, and abdomen from both a front-to-back and side view. Button batteries have a unique look on these X-rays, showing a "step-off" on the side view and a "double-density" or halo sign on the front-to-back view. Additional X-rays may be ordered from different angles for accurate diagnosis. - Endoscopy: For higher-risk patients, such as children under six years old or those who have swallowed batteries larger than 15 millimeters, an endoscopy may be done to remove the battery if it hasn't moved beyond the stomach after 4 days. In some cases, an endoscopy may be done early on to prevent potential damage to the esophagus. - Angiography: If there is a suspicion that a blood vessel might be involved, an angiography may be considered to assess the extent of any injuries or potential complications after the battery is removed.

The treatment for disk battery ingestion depends on the specific circumstances. For patients who do not have any symptoms and the battery has moved past the esophagus, close monitoring and follow-up X-rays after 10 to 14 days are recommended. However, for higher-risk patients, such as children under six years old or those who have swallowed larger batteries, additional X-rays may be done in 4 days. If the battery has not moved beyond the stomach by then, endoscopic removal is recommended. Immediate endoscopic removal is advised for all other situations. The location of the procedure is important, and high-risk cases may be best handled in a heart cath lab or a general operating room. The specifics of how the battery will be removed depend on its location and any potential complications.

When treating Disk Battery Ingestion, there can be several side effects and considerations to keep in mind. These include: - For patients who don't have any symptoms and the battery has moved past the esophagus, there is typically a low risk of serious health problems. However, close monitoring and follow-up X-rays are recommended. - For higher-risk patients, such as children under six years old or those who have swallowed larger batteries, additional X-rays and early endoscopy may be necessary. - Immediate endoscopic removal of the battery is advised in all other situations. - The location where the procedure takes place is important, especially if there is a risk of bleeding or if it may not be possible to remove the battery using an endoscope. - High-risk cases may be best handled in a heart cath lab or a general operating room, which have better imaging technology and the possibility of switching to open surgery if necessary. - Special care should be taken to coordinate with medical and surgical specialists as needed for each individual case. - Patients should not eat or drink anything, and their airways should be protected during the procedure. - The specifics of how the battery will be removed depend on its location in relation to major blood vessels. An angiography may be considered if a blood vessel is suspected to be involved. An endoscopy may be done after removing the battery to assess any injuries or potential complications.

The prognosis for disk battery ingestion is generally positive, with most cases turning out to be harmless. However, complications can occur and can potentially result in damage to the esophagus, trachea, laryngeal nerve, or related structures. It's worth noting that more than 97% of button battery swallowing cases usually have mild or no effects at all.

Medical and surgical specialists