Ohashi Shinsuke, Kanamori Daisuke, Kaji Sayuri, Uchida Goki, Sugihara Tetsuro, Miyaguni Kazuaki, Fukasawa Nei, Handa Shoko, Kurobe Masashi, Ohki Takao
Pediatric Surgery, The Jikei University School of Medicine, Tokyo, JPN.
Pathology, The Jikei University School of Medicine, Tokyo, JPN.
Cureus. 2024 Oct 16;16(10):e71598. doi: 10.7759/cureus.71598. eCollection 2024 Oct.
More than 3,000 cases of accidental ingestion of coin-shaped lithium batteries (CSLBs) have been reported in the United States. Battery ingestion can cause serious injury and even death. Prior reports have indicated that complications often occur two or more hours after ingestion. However, to date, the temporal changes in esophageal damage remain unclear. To address this knowledge gap, we examined the histological features associated with these temporal changes.
Six piglets were used as models. After laparotomy and thoracotomy, three CSLBs were inserted into the esophagus of each pig. The esophagi were removed for histological examination at 0.5, 1, 2, 4, 6, and 8 hours. The consumed capacities of the batteries were measured after removal.
Mucosal damage began at the margins of batteries, gradually spreading to the centers of the negative pole. At 0.5 hours after implantation, although necrosis at the limbus had reached the muscle layer, it became more extensive with time. At six hours, the full-thickness wall was damaged in all areas of the negative pole. The consumed capacity increased markedly after six hours, at which point holes opened in the outer case on the positive pole of the battery with observed electrolyte leakage. The consumed capacity was correlated with the amount of alkaline hydroxide ions.
Our study revealed changes over time in injury site and depth. Although early diagnosis and treatment are necessary, managing batteries to avoid complications is also important. Additionally, developing safer batteries is warranted.
在美国已报告了3000多例意外摄入硬币型锂电池（CSLB）的病例。摄入电池可导致严重伤害甚至死亡。先前的报告表明，并发症通常在摄入后两小时或更长时间出现。然而，迄今为止，食管损伤的时间变化仍不清楚。为了填补这一知识空白，我们研究了与这些时间变化相关的组织学特征。
使用六只仔猪作为模型。在剖腹术和开胸术后，将三个CSLB插入每只猪的食管。在0.5、1、2、4、6和8小时取出食管进行组织学检查。取出后测量电池的消耗容量。
粘膜损伤始于电池边缘，逐渐蔓延至负极中心。植入后0.5小时，虽然边缘坏死已达肌层，但随着时间的推移坏死范围扩大。6小时时，负极所有区域的全层壁均受损。6小时后消耗容量显著增加，此时电池正极外壳出现孔洞并观察到电解液泄漏。消耗容量与氢氧化碱离子量相关。
我们的研究揭示了损伤部位和深度随时间的变化。虽然早期诊断和治疗是必要的，但管理电池以避免并发症也很重要。此外，开发更安全的电池是有必要的。
