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Ingested foreign body - cylindrical battery

Case contributed by Leonardo Lustosa
Diagnosis certain

Presentation

Reported ingestion of a cylindrical battery a couple of hours ago. Asymptomatic.

Patient Data

Age: 6 years
Gender: Female

Presentation

x-ray

There is a metallic density object in keeping with a cylindrical battery projecting over the left hypochondrium. No signs of obstruction or perforation.

Next day follow-up

x-ray

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.

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