Ingested button battery
Suspected ingestion of a button battery within the last hour. The patient is asymptomatic.
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A metallic foreign body projects over the right upper abdomen. It shows the presence of a double-ring sign and a step-off sign. Given the history, it is an ingested button. It is very likely to be in the stomach.
There is no sign of bowel obstruction. Bilateral lung fields and pleural spaces are clear.
The ingested foreign bodies is a common problem in the children; metal coin and button battery being common. The differentiation between these two is important for management.
The button battery shows a double-ring sign or a halo sign in AP view and step-off sign in the lateral view 2. It is important to zoom in to look for these signs on X-ray. However, two overlapping coins may simulate a ‘halo’ sign on X-ray 1.
- 1. Gan RW, Nasher O, Jackson PB, Singh SJ. Diagnosis of button battery ingestion by 'halo' radiographic sign: an exception to the rule. (2015) BMJ case reports. doi:10.1136/bcr-2015-209908 - Pubmed
- 2. Jatana KR, Litovitz T, Reilly JS, Koltai PJ, Rider G, Jacobs IN. Pediatric button battery injuries: 2013 task force update. (2013) International journal of pediatric otorhinolaryngology. 77 (9): 1392-9. doi:10.1016/j.ijporl.2013.06.006 - Pubmed
- 3. Litovitz T, Whitaker N, Clark L, White NC, Marsolek M. Emerging battery-ingestion hazard: clinical implications. (2010) Pediatrics. 125 (6): 1168-77. doi:10.1542/peds.2009-3037 - Pubmed