Button battery – oesophageal — RACP Paediatrics MCQ

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EasyGIButton battery – oesophagealRACP Paediatrics

A 3-year-old swallowed a 20 mm diameter button battery (confirmed on X-ray to be in the oesophagus). The child is asymptomatic. What is the most appropriate management?

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Correct answer: E — Urgent endoscopic removal

Button battery impaction in the oesophagus is a time-critical emergency. Mucosal injury can occur within 2 hours and perforation within 8 hours due to electrical current and alkali generation. Per RCH Melbourne and NCCMERP guidelines, urgent endoscopic removal within 2 hours is mandatory regardless of symptoms. Delay can result in aorto-oesophageal fistula and death.

Reference: RCH Melbourne – 2024 – Foreign Body Ingestion CPG; RACP Paediatric Curriculum – Emergency