Tracheal injuries due to button battery aspiration - an in vitro study

Introduction Both cases of ingestion and aspiration of button batteries have become more and more of a medical emergency in recent years. They pose a life-threatening situation, especially for newborns and children. Due to their occurrence in everyday objects and toys, they are often available in households in different discharge states. The aspiration of button batteries is statistically the rarer form but offers a comparable risk of organ damage. The study aimed at the pathomechanism and damage pattern of the trachea by button battery cells.

Methods Lithium button batteries (3.2V) were exposed in porcine trachea preparations and incubated at 37 ° C. At intervals of up to a total of 36 h, measurements of pH, voltage, and discharge current were made. The preparations were then fixed and stained after histological sectioning and analyzed macroscopically and microscopically.

Results The investigations revealed an electrolysis reaction within the moist milieu of the tracheal tissue immediately after the beginning of the exposure. Consecutive necrosis occurred at the positive and negative battery electrode. The colliquative necrosis that occurred in the alkaline area produced profound tissue damage beyond the basal membrane to the cartilage of the trachea after 2 h of exposure. After 12 h, there was fulminant necrosis of the annular ligaments.

Discussion The aspiration of button batteries, in addition to the acute airway obstruction, represents a life-threatening risk. The electrolysis reaction produces tissue damage to the tracheal mucosa after a short exposure time, which can progress to the destruction of the organ wall. These results underline the necessity of emergency foreign body removal.

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Publication History

Article published online:
10 June 2020