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Case 119: Distressed Mother

A mother was watching when the batteries fell out of her 4 year olds toy and before she could react he picked one up and swallowed it.

1. Where do you think the battery is?

There is a swallowed foreign body. On the closer image it is a size AA battery. The battery seems to be in the dependent part of the stomach. Depending on the history this can help. if the battery has only recently been ingested, then it probably is in the stomach.

2. What are the options for treatment?

The two basic options are to await passing or intervention for removal. Endoscopy for retrieval is probably not warranted in this case. The battery has negotiated the oesophagus and its several narrowings and sphincters. The risk of alkaline leakage is probably only important if the battery was still lodged in the 'acid free' oesophagus. In the stomach any alkali will be neutralised. These patients can be managed as outpatients after advice to the parents and serial xrays every 48 hours to ensure that the object is passing.