A DANGEROUS ENCOUNTER OF BUTTON BATTERY INGESTION IN A TODDLER - COMPLICATIONS AND POST REMOVAL MANAGEMENT CHALLENGES

Abstract

Button battery ingestion (BBI) in toddlers is a paediatric emergency requiring immediate endoscopic or surgical intervention, as delayed treatment can be fatal. The ideal removal window is within 2 hours, but this is often missed due to nonspecific symptoms. Prolonged exposure to the battery's corrosive effects can cause severe complications, including tracheoesophageal fistula (TEF) and aortoesophageal fistula (AEF), which may be fatal. Reported the case of a 2-year-3-month-old boy who presented to the Emergency Department three days after ingesting a 3×3 cm button battery. His non-specific symptoms led to a missed diagnosis during an earlier visit to a general practitioner. Diagnosing the condition was further complicated by the absence of significant findings on physical examination. However, a detailed history revealed the sudden onset of symptoms and an episode of unsupervised play before symptom onset, raising suspicion of foreign body ingestion. An immediate anteroposterior and lateral neck and chest X-ray confirmed the diagnosis. The button battery was successfully removed endoscopically. However, the delayed presentation resulted in complications, including mucosal injuries and pus collection. The patient received intravenous fluids, antibiotics, and steroids to prevent further complications. In this case, the child’s non-citizenship status and financial constraints posed additional challenges to proper post-removal monitoring and surveillance. This case report highlights the importance of early recognition of BBI in high-risk groups as a paediatric emergency and emphasizes the need for diligent post-removal surveillance. Ultimately, this report underscores the critical role of timely intervention and preventive measures in such cases.