Nasal button battery
Updates to Case Attributes
Ingested, inhaled or inserted button batteries require a high index of suspicion and prompt medical attention. A range of different button batteries are available including alkaline, lithium, manganese, mercury, silver and zinc. Batteries contain an anode, cathode and electrolyte soaked spacer 1.
A number of mechanisms by which batteries cause injury have been proposed including; leakage of battery contents, local pressure/ischaemic necrosis, local current and alkaline fluid generation through contact with moist mucosa (nasal or gastrointestinal) resulting in caustic and electrical burns in the surrounding tissue 2.
Button batteries can cause damage within hours of ingestion/insertion and require prompt identification and referral for removal. Delayed battery removal from the nose can result in mucosal ulceration, epistaxis, septal perforation, saddle deformities, chondritis, atrophic rhinitis, alar collapse, and nasal/choanal stenosis 3. Delayed battery removal from the digestive tract can cause catastrophic complication including perforation, tracheal-oesophageal fistula or oesophago-aortic fistula 4.
Radiologically it is important to identify button battery compared to another radiopaque foreign bodies such as a coin. Frontal radiographs will typically demonstrate a halo/double density sign alerting the presence of a button battery button. Where clinical doubt exists an orthogonal lateral radiograph should be obtained which usually reveals a stepped profile 2. Given the plane of the button battery in this case the frontal view revealed the stepped profile, and the lateral the halo/double density sign.
-<p>Ingested, inhaled or inserted button batteries require a high index of suspicion and prompt medical attention. A range of different button batteries are available including alkaline, lithium, manganese, mercury, silver and zinc. Batteries contain an anode, cathode and electrolyte soaked spacer <sup>1</sup>.</p><p>A number of mechanisms by which batteries cause injury have been proposed including; leakage of battery contents, local pressure/ischaemic necrosis, local current and alkaline fluid generation through contact with moist mucosa (nasal or gastrointestinal) resulting in caustic and electrical burns in the surrounding tissue <sup>2</sup>.</p><p>Button batteries can cause damage within hours of ingestion/insertion and require prompt identification and referral for removal. Delayed battery removal from the nose can result in mucosal ulceration, epistaxis, septal perforation, saddle deformities, chondritis, atrophic rhinitis, alar collapse, and nasal/choanal stenosis <sup>3</sup>. Delayed battery removal from the digestive tract can cause catastrophic complication including perforation, tracheal-oesophageal fistula or oesophago-aortic fistula<sup> 4</sup>.</p><p>Radiologically it is important to identify button battery compared to another radiopaque foreign bodies such as a coin. Frontal radiographs will typically demonstrate a halo/double density sign alerting the presence of a battery button. Where clinical doubt exists an orthogonal lateral radiograph should be obtained which usually reveals a stepped profile <sup>2</sup>. Given the plane of the button battery in this case the frontal view revealed the stepped profile, and the lateral the halo/double density sign.</p><p> </p>- +<p>Ingested, inhaled or inserted button batteries require a high index of suspicion and prompt medical attention. A range of different button batteries are available including alkaline, lithium, manganese, mercury, silver and zinc. Batteries contain an anode, cathode and electrolyte soaked spacer <sup>1</sup>.</p><p>A number of mechanisms by which batteries cause injury have been proposed including; leakage of battery contents, local pressure/ischaemic necrosis, local current and alkaline fluid generation through contact with moist mucosa (nasal or gastrointestinal) resulting in caustic and electrical burns in the surrounding tissue <sup>2</sup>.</p><p>Button batteries can cause damage within hours of ingestion/insertion and require prompt identification and referral for removal. Delayed battery removal from the nose can result in mucosal ulceration, epistaxis, septal perforation, saddle deformities, chondritis, atrophic rhinitis, alar collapse, and nasal/choanal stenosis <sup>3</sup>. Delayed battery removal from the digestive tract can cause catastrophic complication including perforation, tracheal-oesophageal fistula or oesophago-aortic fistula<sup> 4</sup>.</p><p>Radiologically it is important to identify button battery compared to another radiopaque foreign bodies such as a coin. Frontal radiographs will typically demonstrate a halo/double density sign alerting the presence of a button battery. Where clinical doubt exists an orthogonal lateral radiograph should be obtained which usually reveals a stepped profile <sup>2</sup>. Given the plane of the button battery in this case the frontal view revealed the stepped profile, and the lateral the halo/double density sign.</p><p> </p>
Updates to Study Attributes
Lateral and frontal X-Rayradiograph reveals a single circular radio-opaque density within the right nasal cavity at the nasal aperture. AThe frontal radiograph reveals a stepped appearance and a Halo/Double density is visible on the lateral plane highly suggestive of a button battery.