Durable cell: a case of multiple AA battery ingestion as a mode of deliberate self-harm

A 54-year-old man was admitted through the emergency department following the ingestion of five AA batteries three days prior to admission. He had a history of personality disorder and had previously swallowed batteries and other foreign bodies on five separate occasions. On one of these occasions he had suffered bowel obstruction as a consequence of battery ingestion, and had required a laparotomy to remove them. On this presentation, he reported swallowing the batteries and had not yet passed any of the batteries per rectum. He complained of some diffuse abdominal discomfort but did not have any clinical features of bowel obstruction or perforation. He was passing flatus and had no nausea or vomiting. On examination, his abdomen was soft to palpation. He was admitted and kept under observation. An abdominal radiograph taken in the emergency department confirmed the presence of five cylindrical radio-opaque objects in his small bowel with no features of obstruction or suggestion of damage to their structural integrity (Figures 1 and 2). Serial abdominal radiographs were taken to track the batteries’ progression along the gut and by day 5 they appeared to have transited to the large bowel. The patient was reviewed by the psychiatric team and was assessed to be fit for discharge with follow-up from community mental health services once he had passed all batteries per rectum. He was discharged home and reviewed in the surgical outpatient clinic several days later with no long-lasting morbidity associated with the episode.