Tracheobronchial injuries from lithium button battery aspiration: In-vitro study of the pathomechanism and injury pattern

Introduction In recent years, button battery (BB) ingestions and aspirations have been an increasing medical issue. The rising number of these emergencies can be explained by the expanding use in everyday life devices. Due to the long shelf life of lithium-based batteries, even older cells can cause serious medical complications. The present study aimed to analyze the pathophysiology of tissue damage caused by BBs in the tracheobronchial system over time.

Methods The battery types CR2032 and CR927 (3.2 / 3.0 V) were exposed to porcine tracheobronchial preparations at 37 ° C at intervals of up to 36 h. After measuring the electrical voltage curve, the discharge current, and the pH changes around the battery electrodes, specimens were fixed and histologically processed. Histological examinations were carried out on cryosections of all examined specimens after H. E. staining.

Results The experiments prevealed an electrolysis reaction within the moist environment of the tracheobronchial tissue immediately after exposure. Consecutive necroses developed in the area of the positive and negative battery electrodes. The colliquation necrosis in the alkaline area caused profound tissue damage beyond the basement membrane to the cartilage tissue after 4 hours of exposure. After 12 h, there was fulminant necrosis of the annular ligaments and the peribronchial tissue.

Discussion In addition to ingestion, aspiration of button cells represents a life-threatening risk. The resulting electrolysis reaction causes tissue damage to the tracheobronchial mucous membrane after short exposure times, which can progress to the destruction of the organ wall. This underlines the need for immediate endoscopic intervention in cases of BB incidents.

Poster-PDF A-1315.pdf

IZKF Würzburg, Clinician Scientist Program, #Z-2/CSP-4

Publication History

Article published online:
13 May 2021