Battery ingestion | Figure 1

CincyKidsRad

Cincinnati Children's Radiology

Battery ingestion

Focused frontal radiograph of the chest (image 1) and abdomen (image 2) show the differences between a button battery (image 1) and alkaline AAA battery (image 2). Button batteries represent an emergency, especially when lodged in the esophagus. The esophageal mucosa and saliva are able to conduct a charge leading to rapid esophageal burns. Button batteries have a characteristic halo lucency which can be used to differentiate the circular metallic object from a coin.

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Coronel image from CT angiogram shows metallic residua (arrow) of the button battery. Ingested button batteries are a medical emergency. The battery can conduct a charge across the tissue leading to soft tissue burns. These burns can lead to esophageal injury as well as adjacent vascular injury. An aortoesophageal fistula is the most feared complication as it can lead to rapid exsanguination.

Fluoroscopic image obtained during endoscopy shows a tracheoesophageal fistula. Contrast is injected into the esophagus. It is then seen filling the tracheobronchial tree. Acquired tracheoesophageal fistulas can be a result of caustic ingestion, impacted esophageal button batteries, trauma, and surgery.

AP (image 1) and lateral (image 2) radiograph of the airway showing ingested button battery with erosion of the inferior margin. The battery is causing significant edema. This is seen on the lateral view where there is widening of the space between the esophagus and trachea, as well as a narrowing of the anterior trachea (arrowhead).

2 year old with ingestion of button battery. Send home or to OR?

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