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Button Battery Oesophageal Emergency — FRCA Final MCQ

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HardPaediatric AnaesthesiaButton Battery Oesophageal EmergencyFRCA Final

A 4-year-old child (16 kg) accidentally ingests a button battery which is lodged in the oesophagus on X-ray. This requires emergency endoscopic removal under GA. What is the specific danger of an oesophageal button battery?

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Correct answer: A — Allergic reaction to the battery components

Button battery impaction in the oesophagus is a paediatric emergency. The battery generates an alkaline solution (sodium hydroxide) at the negative pole through electrolysis of tissue fluid, causing deep liquefactive necrosis. Oesophageal perforation can occur within 2 hours, and fatal aorto-oesophageal fistula (erosion into the aorta) is reported. Removal must occur within 2 hours of ingestion. Anaesthetic considerations: RSI (full stomach, risk of aspiration), shared airway with the endoscopist, risk of bleeding during removal, and the potential need for immediate thoracotomy if major vessel erosion occurs.

Reference: NPIS – 2021 – Button battery ingestion guidelines; APA – 2019 – Emergency paediatric guidelines