Best of five
- A. Observe for spontaneous passage
- B. Push the battery into the stomach blindly
- C. Repeat radiography the next day
- D. Immediate endoscopic removal with assessment for tissue injury
- E. Induce vomiting
FRCS (ORL-HNS) · SECTION 1 SBA
Oesophageal button battery
A 2-year-old has drooling and refuses food. Radiography shows a 20 mm button battery lodged in the upper oesophagus. What is the correct management?
D. Immediate endoscopic removal with assessment for tissue injury
An oesophageal button battery is a time-critical emergency because caustic injury develops rapidly. Removal must not wait for fasting time; airway, perforation risk and post-removal injury assessment require senior multidisciplinary planning.
Why every option is right or wrong
A. Observe for spontaneous passage: Observation is unsafe while a battery remains in the oesophagus.
B. Push the battery into the stomach blindly: Blind advancement can worsen injury and loses the opportunity to assess the oesophagus.
C. Repeat radiography the next day: Delay materially increases necrosis, fistula and haemorrhage risk.
D. Immediate endoscopic removal with assessment for tissue injury: An oesophageal button battery is a time-critical emergency because caustic injury develops rapidly. Removal must not wait for fasting time; airway, perforation risk and post-removal injury assessment require senior multidisciplinary planning.
E. Induce vomiting: Vomiting does not reliably remove the battery and risks aspiration and further mucosal exposure.
What if the scenario changed?
If imaging confirmed a small battery already beyond the stomach in an asymptomatic child, management could be expectant under a specific ingestion pathway.
Independent Clinora educational preparation material; not official JCIE content, an accredited programme, clinical advice, or a substitute for local policy and specialist judgement.
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