Radiographic identification of ingested disc batteries

Abstract

Recently, the hazards posed by the accidental ingestion and impaction of small disc batteries have been widely publicized in the medical and lay press. These foreign bodies, when lodged in the esophagus, leak a caustic solution of 26 to 45% sodium or potassium hydroxide which can cause a burn injury to the esophagus in a very short period of time. Because of the considerable clinical morbidity and mortality from this foreign body, it becomes imperative for the radiologist to quickly and accurately identify disc batteries on plain radiographs. This communication offers a series of radiologic signs important in the identification of disc batteries. When viewed in an anterior projection, disc batteries demonstrate a double density shadow due to the bilaminar structure of the battery. On lateral view, the edges of most disc batteries are round and again present a step-off at the junction of the cathode and anode. These findings are differentiated from the more common esophageal foreign body of a coin which does not have a double density on frontal projection, has a much sharper edge and no visible step-off.

Unwitnessed lithium ion disc battery ingestion: case report and review of best practice management of an increasing clinical concern

“…4 A study involving both radiologists and otolaryngologists reported the combined sensitivity of anteroposterior and lateral plain films in identifying disc batteries to be 80.4 per cent. 5 Underpenetrated films prevented visualisation of a double shadow and significantly reduced the correct identification of batteries.…”

Tension pneumothorax and subcutaneous emphysema during retrieval of an ingested lithium button battery

“…A button battery appears similar to a coin on plain chest radiographs but can be distinguished by a radiolucent halo and notch on anteroposterior and lateral neck views [7]. Complications resulting from battery ingestion depend upon the state of the battery, whether it is intact or damaged, the size and type of battery, and the duration and location of impaction.…”

Cecal Retention of a Swallowed Penny Mimicking Appendicitis in a Healthy 2 Year Old

“…These include button batteries, toothpicks, and safety pins. [15][16][17][18] Focus has been on identifying disc or button batteries in the esophagus radiographically given their propensity to cause injury there. 17 Some foreign bodies have been implicated in perforation and chronic inflammation of the gastrointestinal tract and as causes of appendicitis.…”

“…[15][16][17][18] Focus has been on identifying disc or button batteries in the esophagus radiographically given their propensity to cause injury there. 17 Some foreign bodies have been implicated in perforation and chronic inflammation of the gastrointestinal tract and as causes of appendicitis. Toothpicks have been found to cause acute and chronic abdominal pain with ulceration of the duodenum around the embedded wooden foreign bodies.…”