Evaluation of an Esophageal‑Protective Lithium Coin‑Cell Battery Within Current Management Paradigms

To assess the first lithium coin-cell battery (CCB) technology on the consumer market with ingestion burn protection claims in context of medical management practices.

Cadaveric porcine esophageal model.

Tertiary care children's hospital research institute and third-party laboratory.

Anterior-posterior X-ray imaging was performed. Using in vitro porcine tissue segments, traditional CCBs and protective CCBs were assessed for visible appearance and surface pH over 60 minutes; another group was assessed for 24 hours. A separate experiment evaluated existing protocols to administer honey/sucralfate and perform 0.25% acetic acid irrigation.

All protective CCBs demonstrated diagnostic double-ring/halo sign on X-ray. Traditional CCBs demonstrated diffusely highly alkaline pH of 13 and significant tissue necrosis. For protective CCBs, regions of tissue pH increased to 12-13; however, substantially reduced tissue injury without obvious necrosis was noted. At 24 hours, protective CCBs compared to traditional CCBs maintained reduced visible tissue injury at both positive and negative poles. Honey, sucralfate or 0.25% acetic acid irrigations effectively neutralized pH.

To our knowledge, this is the first study in the medical literature to assess recently marketed protective CCBs. X-ray diagnosis, preremoval honey/sucralfate use, emergent removal for esophageal lodgment, postremoval 0.25% acetic acid esophageal irrigation practices should not change. While protective CCBs showed substantial reduction of injury severity, the highly alkaline pH at negative pole still warrants neutralization treatments and further study. Widespread adoption of advanced technologies for child safety across the battery, electronics, and consumer goods industries could prevent severe injuries or deaths.