Yoshikawa T, Asai S, Takekawa Y, Kida A, Ishikawa K
Department of Otorhinolaryngology, Nihon University School of Medicine, Itabashi, Tokyo, Japan.
Crit Care Med. 1997 Dec;25(12):2039-44. doi: 10.1097/00003246-199712000-00022.
In recent years, small high-performance batteries have become very popular. With this increasing miniaturization of batteries, clinicians have noted an increasing frequency rate of esophageal injury due to battery ingestion by infants. The situation is associated with severe injury to the esophagus due to the electrical current produced, particularly in the case of high-performance batteries producing high currents. The pathophysiologic features and complications of esophageal battery burns have not been thoroughly investigated. Our study intended to investigate the pathophysiologic features and complications of esophageal battery burn.
Open, randomized, controlled study.
Experimental animal laboratory in a university hospital.
Male adult mixed-breed rabbits, 22 wks old and weighing 3 to 3.5 kg.
The experimental rabbit model of esophageal injury due to battery ingestion described herein was designed to study not only the direct influence of contact with the battery but also damage to neighboring tissues and the biochemical and pathologic mechanisms of injury. We investigated the relationship between the direction of the inserted battery and the mechanism underlying these complications. Esophageal burn injury was created by placing a 3-V battery into the esophagus for 9 hrs.
The cathode side of the esophagus became increasingly alkaline, while the anode side was acidic. Low-voltage battery burns are likely to be due to secondary chemical reactions caused by the electric current because of acid generated at the anode and alkali at the cathode using a micro pH meter. Injury was significantly more severe on the alkaline side when a battery was placed with its cathode directed toward the trachea. Alkaline complications affecting neighboring tissues were more severe than acid complications. These results indicate that as well as the esophageal mucosa itself being injured, deleterious effects are exerted on surrounding tissues, the severity of which vary depending on the orientation and duration of the battery being lodged in the esophagus.
The direction of the battery cathode, which produces alkali, is important in determining the severity of complications. Based on our investigation of the underlying mechanisms of these complications, we advocate the establishment of treatment guidelines for battery swallowing accidents.
近年来，小型高性能电池变得非常流行。随着电池的日益小型化，临床医生注意到婴儿因吞食电池导致食管损伤的频率不断增加。这种情况与所产生的电流导致的食管严重损伤有关，特别是在高性能电池产生高电流的情况下。食管电池烧伤的病理生理特征和并发症尚未得到充分研究。我们的研究旨在调查食管电池烧伤的病理生理特征和并发症。
开放、随机、对照研究。
大学医院的实验动物实验室。
22周龄、体重3至3.5千克的成年雄性混种兔。
本文所述的因吞食电池导致食管损伤的实验兔模型，不仅旨在研究与电池接触的直接影响，还研究对邻近组织的损害以及损伤的生化和病理机制。我们研究了插入电池的方向与这些并发症潜在机制之间的关系。通过将一个3伏电池放入食管9小时造成食管烧伤损伤。
食管的阴极侧碱性越来越强，而阳极侧呈酸性。使用微型pH计测量发现，低电压电池烧伤可能是由于电流引起的二次化学反应，因为阳极产生酸，阴极产生碱。当电池阴极朝向气管放置时，碱性侧的损伤明显更严重。影响邻近组织的碱性并发症比酸性并发症更严重。这些结果表明，除了食管黏膜本身受到损伤外，周围组织也受到有害影响，其严重程度取决于电池在食管中的方向和停留时间。
产生碱的电池阴极方向对于确定并发症的严重程度很重要。基于我们对这些并发症潜在机制的研究，我们主张制定电池吞咽事故的治疗指南。
