Button battery ingestion in children—a potentially catastrophic event of which all radiologists must be aware

Abstract

Foreign body ingestion is common in infants and young children and can cause numerous complications, mainly if ingested and left in place for prolonged periods. In recent years, particular dangers, specifically from ingested button batteries, have become increasingly recognized as a public health issue. Of particular note is the rapid onset of full thickness burns and oesophageal perforation which may occur within as little as 2 h following the ingestion of button batteries. The aim of this review is twofold: (1) to increase awareness of the need for rapid action from radiologists, emergency care physicians and paediatricians on identifying a button battery impacted within the oesophagus, and (2) to review the imaging appearances that can distinguish button batteries from other similar appearing foreign bodies, most notably coins.

Button Battery Ingestion: A Case Report

“…Radiographic clues to a button battery ingestion include a "double-rim" or "halo" sign on the anteroposterior view, which should distinguish a button battery from a coin. In a lateral view, a "step-off " may be visible, as the smaller diameter anode (negative pole) projects from the larger cathode (positive pole) Semple, Calder, Ramaswamy, & McHugh, 2018).…”

A 3‐year‐old boy with rapid obstructive symptoms secondary to coin ingestion and gastric impaction

“…9 Pay careful attention to coin edges on X-ray for the double-halo sign synonymous with a button battery ingestion, although given its orientation that would not have been possible in this case. 10 The most common serious complication of coin ingestion is esophageal impaction. Esophageal impaction should be managed quickly, within 24 hours, to prevent significant esophageal mucosal damage.…”

Endoscopic retrieval of a button battery using the tip of a magnetic tube

“…When a lithium button battery is swallowed, it secretes an alkaline liquid as a result of electrolysis, causing gastrointestinal ulceration, which can sometimes lead to perforation . The battery should be promptly retrieved, but food residue may make locating it difficult, and its smooth, circular shape makes it difficult to grasp using forceps.…”