Presentation
Reported ingestion of a cylindrical battery a couple of hours ago. Asymptomatic.
Patient Data
There is a metallic density object in keeping with a cylindrical battery projecting over the left hypochondrium. No signs of obstruction or perforation.
The battery now projects over the right lumbar region. Multiple air-fluid levels are noted, which suggests bowel obstruction has occurred.
Case Discussion
In the present case, the history of battery ingestion was corroborated by the radiographs.
Ingested foreign body management usually depends on its location and properties. Most foreign bodies that passed beyond the oesophagus can be managed with observation.
Unlike button batteries, cylindrical batteries are usually safe unless their casing has been damaged (such as if it is chewed), thus they can usually be managed as a regular blunt object.
In the present case, due to the asymptomatic presentation and no suspicion of casing damage, the initial management was clinical observation, with a follow-up radiograph the next day. The serial exam, however, showed signs of bowel obstruction, and the case was referred to the paediatric surgeon for evaluation.