Button battery ingestion

Case contributed by Ashmitha Kumar
Diagnosis certain

Presentation

Brought in to the Emergency department by her father after a witnessed button battery ingestion.

Patient Data

Age: 20 months
Gender: Female
x-ray

A round radiopaque 22 mm foreign body in the proximal esophagus. The object had a halo sign /double rim sign which indicated the manifestation of two circular pieces, leading to the chief diagnosis of button battery ingestion.

Case Discussion

A radiograph of her chest was done approximately one hour after ingestion showing a round radiopaque 22 mm foreign body in the proximal esophagus. The object had a halo sign /double rim sign which indicated the manifestation of two circular pieces, leading to the chief diagnosis of button battery ingestion. An emergent flexible endoscopy was done by the gastroenterologist which showed extensive erosion and ulceration on the proximal esophagus despite just a total of 3 hours of button battery ingestion.  

Often button battery ingestion can look similar to coin ingestion. One way to differentiate between both is to identify a "step-off" sign on the lateral view seen on button battery ingestion in contrast to coin ingestion.

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