Ingested cylindrical batteries in an incarcerated male: a caustic tale!

Abstract

A 37-year-old incarcerated man presented to the accident and emergency department following the deliberate ingestion of eight cylindrical batteries. He also admitted to inserting a razor blade wrapped in cling-film into his rectum; in addition, he sustained a self-inflicted laceration to his left antecubital fossa, using the metal casing from a battery. His medical history included a borderline and emotionally unstable personality disorder. He had ingested several batteries 12 months previously and required an emergency laparotomy to retrieve them. On the present admission, as there was no clinical evidence of small bowel obstruction, he was treated conservatively with serial radiographs. Following conservative management, the batteries failed to progress through the gastrointestinal tract, hence a laparotomy was performed and all the batteries were extricated. This paper discusses the management and associated sequelae of patients presenting following the intentional ingestion of a battery.

Multifaceted Assessment of a Prisoner Ingesting Nine Batteries for Suicidal Purposes

“…Presenting symptoms following ingestion of a foreign object include epigastric pain in 55%, vomiting in 16%, dysphagia in 7%, pharyngeal discomfort in 4% and chest pain in 3% of the cases, whereas 30% do not experience any symptoms Consistently, the patient reported by Dunphy et al [11] did not experience symptoms of nausea/ vomiting or clinical findings suggesting intestinal obstruction. Our patient had complaints of nausea, vomiting and abdominal pain.…”

“…Malliwal et al [10] reported a 54-year-old male with a history of personality disorder who swallowed five AA batteries. A case of multiple foreign body ingestion was reported by Dunphy et al [11] in a 37-year-old incarcerated male who swallowed eight batteries. Our literature review did not identify any reports of ingestion of a higher number of batteries than in the case we present here.…”

“…In our case, remaining batteries were naturally removed from the gastrointestinal system within 24 hours without any complications. In the case reported by Dunphy et al [11], the batteries failed to progress through the gastrointestinal tract, requiring surgical intervention. Foreign body ingestion is a problem frequently encountered by emergency room physicians and gastroenterologists.…”

Endoscopic Retrieval vs Observation in Cylindrical Battery Ingestion

“…We summarize these cases in the Table. [10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25] Most reported cases involved patients who were asymptotic after ingestion. If symptoms did occur, they usually manifested as upper GI complaints or abdominal pain.…”

“…13 Our review revealed that in all cases with evidence of corrosive changes, leakage, or damage to the battery casing, patients were symptomatic or had evidence of mucosal damage. 10,11,13,14,21,22 In 2017, Tien and Tanwar reported a case of a 3-battery ingestion that resulted in gastric ulcers and gastritis within 14 hours, despite the patient denying destruction of the battery cases. 24 Our review of the abdominal x-rays provided with the case suggested distortion of the battery casing that would have explained the gastric find-ings.…”