Presentation
Suspected ingestion of a button battery within the last hour. The patient is asymptomatic.
Patient Data
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.
Case Discussion
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.