Button battery ingestion: a case report and review of the literature

Disc batteries represent a distinct type of pediatric foreign body because of their potential for severe morbidity and mortality. We present the case of an 18-month-old boy who ingested a lithium battery and, despite a delay in diagnosis, had a favorable outcome. Button batteries are being used with increasing frequency in a variety of devices including hearing aids, watches and calculators. Most contain a heavy metal such as mercury, and an alkaline electrolyte. Esophageal impaction results in a corrosive esophagitis leading to perforation with the attendant sequelae. Injury may occur by four mechanisms: (1) electrolyte leakage from batteries; (2) alkali produced from external currents; (3) mercury toxicity, and (4) pressure necrosis. Early diagnosis and urgent removal are required for esophageal impaction. More distal sites can be managed conservatively with spontaneous passage occurring in the majority of cases. Prevention should be directed at placing the cells out of reach and child-proofing battery-powered appliances.