Button battery induced cell damage: A pathophysiological study

Button batteries (BB) are frequently swallowed and must be removed immediately as, if they remain in the esophagus, they can cause severe damage with fatal prognosis. To better understand the molecular mechanism of esophagus damage, we performed a study aimed to analyze heat production, pH variation, electrical work and metal release from BB incubated in cell culture media. Cytotoxicity and apoptosis induced in a human monocytes cell line (U937) was also investigated.Calculated transferred heat was around 244 J with a maximal increase of temperature of 7.26 K/g medium whose pH, reflecting medium electrolysis, was 12.2 after about 2 h incubation. Release of metals also occurred. Only 49.7 ± 1.9% of U937 monocytes remained viable after 90 min of incubation in DMEM containing BB. Those results suggest that BB discharge induce cytotoxicity and tissue injury probably due to multiple combinations of at least thermic, caustic and toxic phenomena. As maximal effects occurred in less than 2 h, they prompt for fast removal of battery from esophagus.