Foreign body

Case contributed by Dr Fadi Ali

Presentation

Suspected ingestion of a button battery 2 hours ago. Asymptomatic at presentation

Patient Data

Age: 5 years
Gender: Female
X-ray

A well-defined metallic foreign body seen in the right upper abdomen. showing the double ring sign. Considering patient history, it is an ingested button battery. 

There is no definite sign of perforation or bowel obstruction.

The visible lung fields are clear.

follow-up after 1 day

X-ray

On the follow-up x-ray performed one day later, the foreign body is seen in the left upper abdomen. The double ring sign is more obvious especially at the magnified image.

follow-up after 1 day

X-ray

On the follow-up x-ray one day later (two days since the ingestion), the foreign body is not visualized, suggestive of its passing out with the feces.

Case Discussion

The differentiation between a button battery and a coin is important for management.

The button battery shows a double-ring sign or a halo sign in frontal projection, the coin appears homogeneous with a smooth margin.

A button battery in the esophagus has to be urgently removed as major corrosive injury can occur within 2 hours of ingestion.

Button batteries, if passed through the stomach, can be observed until passed in the stool as then they pose only minimal risk of a burn injury.
 

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