Histological analysis and physical basis of oesophageal tissue damage due to button battery ingestion
18 April 2018 (online)
Due to the use of button batteries (BB) in devices of daily life, there is a high risk of injury by accidental ingestion. In these cases complications occur, when the foreign body gets trapped in the area of the esophageal constrictions. Depending on the exposure time, this can lead to ulcerations, perforations and damage to the surrounding structures. To further understand the pathophysiology and physics of this lesion, systematic investigations on porcine esophageal specimens were performed.
The lithium BB type CR2032 was exposed in esophageal preparations under physiological conditions. Examinations of the surrounding pH, the battery voltage, the discharge current and the histological alterations were performed over a period of 24h.
The investigations showed that under physiological conditions an electrolysis reaction is responsible for an acidic environment around the positive and a basic environment in the region of the negative battery electrode. In the histologic sections a coagulation necrosis was found on the side of the positive and colliquation necrosis occurred on the side of the negative battery electrode. From 12h exposure time on a progressive tissue damage up to the lamina muscularis could be detected.
Swallowed BB represent a life-threatening situation. The characteristic design of the batteries is significant for the pathophysiology of the injury. After only a few hours, a tissue damage of the mucosa was detected, which was continuously progressive. The findings provided insight into the pathophysiology of the injury and highlighted the urgency of immediate endoscopic foreign body removal.
No conflict of interest has been declared by the author(s).