Effects of tap water on esophageal burns in dogs from button lithium batteries

Incidences of swallowing lithium batteries have been increasing. A lithium battery is more dangerous than button alkali batteries because the tissue erosion and perforation of the esophagus is more rapid than with button alkali batteries. We hypothesized that a bolus fresh water wash out or dilution of the alkali produced by the direct current flow, and/or inhibition of the alkali production by interrupting the direct current flow, might lessen the severity of the necrotic injury at a contact esophageal site with a battery. Model CR2032 lithium batteries were fixed in the esophagus of 21 adult mongrel dogs for 15, 30, 60 or 90 min. In 9 of the dogs serial 20 mL boluses of tap water (adjusted pH at 7.0 by bicarbonate) were administered at 15-min intervals after placement of the battery. The esophageal injuries were graded microscopically according to the depth of the necrosis. The consumed electricity of the batteries was also evaluated. Serial bolus administration of water reduced the consumed electricity of the batteries significantly 30 and 60 min after fixation and delayed the corrosive change in a contact esophageal area during the first 30 min. Dosing with tap water as soon as possible within 30 min after ingestion seemed a useful first aid measure to prevent esophageal injury after accidental swallowing of a lithium battery.