E1537. Button Battery Ingestion: A Potentially Catastrophic Pediatric Emergency, Imaging Protocol, and Case-Based Review of Findings
  1. Surabhi Subramanian; Alberta Children's Hospital
Foreign body ingestion is a common occurrence in the pediatric emergency departments. Coins followed by button batteries are the more common culprits. Ingestion of button battery can be catastrophic due to various factors. The common mechanisms of injury are tissue pressure effect, local electrical current due to positive and negative poles, and corrosive injury due to leaking chemicals from the battery. The most common site of impaction is the cricopharynx.

Educational Goals / Teaching Points
Understand the mechanism and mode of presentation of button battery ingestion in paediatric patients. Outline the recommended imaging algorithm for imaging in children presenting with button battery ingestions for early detection of complications and their management. Discuss the common imaging presentations and catastrophic complications of button battery ingestion.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Potentially lethal complications like trachea-esophageal fistula, esophageal perforation, and aorto-esophageal fistulas are of particular concern. They can develop over a period of time due to ongoing tissue injury. The radiologist should be aware of imaging features and protocols. Radiographs, CT with an angiogram, MRI with angiogram, and upper GI fluoroscopy studies are being done to investigate such patients and their follow-up. We follow an imaging algorithm for our patients which includes interval esophagogram and CT/MRI chest with angiogram to detect any complications arising over a period of time.

Common complications and imaging algorithms for button battery ingestion are reviewed.