小児のボタン型リチウム電池食道異物の1例

コイン異物との鑑別について

抄録

A 14-month-old female infant who ingested‘something’was brought to our emergency department, crying severely. PA and lateral chest X-rays showed a coin-shaped foreign body lodged in the esophagus at the thoracic inlet. Three hours after ingestion, the foreign body was removed by esophagoscopy under general anesthesia. On removal, the foreign body proved to be a lithium battery, measured 20mm in diameter, but not a coin. The case of the battery was not perforated. Abundant black debris was found around the lodged battery, and the esophageal mucosa was eroded. The infant was treated with intravenous antibiotics and steroids. After two weeks, she was discharged without any sequelae.
Button batteries can cause esophageal necrosis by sodium hydroxide produced from local direct current. Therefore, unlike coin foreign bodies, button batteries should be removed as soon as possible if lodged somewhere in the esophagus. We suggested two points of differential diagnosis of button batteries from coins: (1) double contour in the PA X-ray; (2) continuous pain, especially manifested by crying in children.