Presentation
3 years old boy presented with foreign body ingestion. ? button battery vs coin.
Patient Data
Halo sign (double ring sign) is pathognomonic for button battery ingestion.
The step-off sign on the lateral view of the x-ray is pathognomonic for the button battery in the esophagus.
Case Discussion
Halo sign (double ring sign) in AP view and step-off sign in the lateral view of the x-ray are pathognomonic for button battery ingestion compared to a coin. An urgent oesophagoscopy for battery removal needed. After removal of the battery, further contrast swallow examination can be perform to exclude esophageal injury (initially leak and later a stricture).