Button Battery Ingestion: A Tiny Object with the Potential for a Catastrophic Outcome

Foreign body ingestion is a common complaint encountered in the emergency department among both adults and children. Children under the age of 6 years are at especially high risk of foreign body ingestion, including coins, toys, jewelry and batteries. The button battery is the most common battery ingested and has the highest potential for serious and fatal injuries in infants and children. Over the past decade there has been a dramatic increase in the incidence of button battery ingestions directly related to the widespread expansion and availability of common consumer electronics powered by button batteries. Most ingested foreign bodies pass through the gastrointestinal system spontaneously and without complications. However a button battery that becomes lodged in the nasopharynx, oropharynx, trachea, esophagus, or any part of the gastrointestinal tract is associated with an exceptionally high rate of complications, including death. Button batteries lodged in the esophagus are especially dangerous and require immediate removal as serious tissue damage may occur in as little as 2 hours. Emergency care providers must maintain a high index of suspicion and be fully aware of the dangers of button battery ingestion. Initial symptoms may be variable nonspecific symptoms including fussiness, decreased appetite or refusal to eat or drink, drooling, difficulty swallowing, hematemesis or abdominal pain. Obtaining plain radiographs for foreign body ingestion should not be delayed. In addition, emergency care providers can be advocates for the safety and protection of button battery ingestions through knowledge dissemination and public advocacy.