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Three Part Question

In [children who have swallowed batteries] do [serial abdominal x-rays] reduce the [incidence of perforation and need for later intervention]?

Clinical Scenario

A mother brings her 3 year old to the department, concerned that she has swallowed a battery. X ray reveals a metallic opacity in the abdomen which could very likely be a battery. You reassure the mother but she is concerned about the passage of the battery and wants to come back for a repeat film. You wonder whether you should perhaps make sure it's passing distally to prevent it decaying inside the body.

Search Strategy

Medline 1966 to April week 4 2005 using the OVID interface
Embase 1980-week 19 2005 using the OVID interface
Medline 1966: [Battery.mp OR batteries.mp] AND [ingestion.mp OR swallow$.mp OR eat$.mp} AND {perforat$.mp OR corrode.mp OR exp corrosion OR corrosion.mp]. 28 papers found.
Embase: [exp electric battery OR battery.mp OR batteries.mp] AND [ingestion.mp OR exp ingestion OR exp swallowing OR swallow$.mp OR eat$.mp] AND exp duodenal perforation OR exp perforation OR perforate$.mp OR corrode$.mp OR exp corrosion OR corrosion.mp]. 21 papers found.

Search Outcome

29 papers found overall of which none contained any data to answer the question posed.

Comment(s)

A number of authors expressed a personal view that serial x-rays were necessary to ensure that the battery had been passed, but none offered any direct evidence for this. Other authors felt that "nature should be allowed to take its' course – but again none offered supporting evidence.

Clinical Bottom Line

Some research is required to clarify whether there is a need for serial x-rays after battery ingestion. In the mean time local expert advice should be followed.