A 66-year-old woman had to undergo surgery to remove 46 batteries from her stomach, in an unusual case of self-harm.
The surgery which was performed at St Vincent’s University Hospital three weeks after she presented to the Emergency Department followed the ingestion of an unknown number of cylindrical batteries.
The case, covered in this month’s edition of the Irish Medical Journal, detailed how an abdominal X-ray confirmed the presence of 51 batteries located throughout her abdomen.
The woman did not show any obvious signs of suffering from an obstruction or internal perforation of organs and none of the batteries were damaged passing into the stomach following her swallowing them.
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Doctors decided to treat the woman through “conservative management” and five AA batteries successfully passed out of her body over a one week period.
The patient underwent daily clinical examination and weekly abdominal X-rays. Serial X-rays over three weeks revealed that the remaining batteries had failed to progress. The patient began to complain of abdominal pain and anorexia.
The medics made a decision to perform a laparotomy where they identified a distended stomach pulled down into her lower abdomen. Forty six cylindrical batteries were removed from her stomach through a small gastrostomy and four batteries located in the colon were milked into the rectum and removed via her back passage using an anal retractor and long forceps.
A follow-up X-ray confirmed all of the batteries she ingested had been removed and the patient made a full and uneventful recovery.
The co-authors of the Study, Management of Cylindrical Battery Ingestion, said: “Ingestion of cylindrical batteries is a rare method of deliberate self-harm that has the potential for several serious complications, including injury to the digestive system, perforation, obstruction, and blockages of the coronary artery.
Reported cases suggest that the incidence of severe and fatal battery ingestions are increasing and current treatment paradigms may be inadequate. Many of these cases pertain to the paediatric population and relate to button battery ingestion.”
The authors point out that ingestion of the larger cylindrical batteries is less frequently encountered and so there is no clear practice and guidelines need to be developed.
The co-authors add: Potential options for dealing with cylindrical battery ingestion include conservative management, endoscopic extraction, or surgical retrieval. The method chosen is determined based on variables such as the type and number of batteries, location, structural integrity of each battery case and the overall clinical picture.
“This report describes the case of a patient who presented following the ingestion of a large number of cylindrical batteries as a method of deliberate self-harm. However, the potential of cylindrical batteries to result in acute surgical emergencies should not be underestimated.”
They highlight that using daily clinical exams and weekly plain films of the abdomen, conservative management is possible if a small number of batteries are ingested and make it to the stomach.
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