Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Immediate removal of the battery may be indicated in the following cases:
If X-rays show the battery is located in the esophagus (food pipe)
If the person develops symptoms such as abdominal pain or vomiting blood. Minor changes in stool color or minor vomiting are not indications for removal.
If the battery is large (15.6 mm or bigger) and the child is younger than 6 years
of age and the battery does not pass through the stomach within 48 hours
Battery removal will likely be accomplished with an endoscope. An endoscope is a flexible fiber optic scope with ports for grasping devices to be passed through it. This scope is passed through the mouth and into the esophagus and stomach.
Endoscopy allows for battery removal and visual inspection of the esophagus for damage. If an endoscope is not available, removal by other means may be attempted.
Transit time for disk batteries through the digestive tract ranges from 12 hours to 14 days. The majority (85.4%) of cells are passed in the stool within 72 hours. At home, strain stools for passage of the battery.
Infrequent abdominal X-rays should be taken to confirm forward progression of the battery.
If the battery contains mercury and is found to have fragmented (viewed by an X-ray), blood and urine mercury levels are necessary. Medication to lower mercury levels should be used only when abnormal levels are found.
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