Patient selection: disc battery ingestion known or suspected
Indications for localization of the battery:
(1) age <= 12 years of age OR battery diameter > 12 mm
(2) history of esophageal disease
(3) multiple batteries swallowed
(4) concurrent ingestion of a magnet
(5) symptomatic
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Condition
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Management
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magnet co-ingested
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Remove battery immediately by whatever means necessary.
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symptomatic
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Remove battery immediately if it can be reached by endoscope. Remove surgically if it meets the criteria below..
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age < 6 years AND battery diameter >= 15 mm
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If battery still stomach after 4 days, then remove endoscopically.
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other
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Manage the patient at home but be sure that the battery is passed in stool.
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Indications for surgical removal when the battery is beyond the reach of an endoscope:
(1) occult or clinical bleeding
(2) persistent or significant abdominal pain
(3) vomiting
(4) acute abdomen
(5) fever
(6) anorexia
The patient should be monitored for complications:
(1) A serious burn may require hospitalizaton and aggressive management.
(2) The patient should be able to return for assessment during the next 3 weeks in the event of delayed complications.
(3) Late complications such as stricutre may appear over weeks or months.
