An 18-month-old boy who swallowed a button battery two hours ago has a chest radiograph showing a round metallic opacity in the proximal oesophagus with a double rim or halo appearance. He is drooling but haemodynamically stable. What is the correct management?
- A Serial radiographs every 24 hours with observation
- B Immediate rigid oesophagoscopy and removal ✓
- C Honey administration orally and reassessment in 12 hours
- D Induced emesis followed by barium swallow
Correct answer: B. Immediate rigid oesophagoscopy and removal
Explanation
An oesophageal button battery is an emergency requiring endoscopic removal without delay, ideally within 2 hours of presentation. Current generates hydroxide at the negative pole, producing liquefaction necrosis, and perforation or tracheo-oesophageal fistula can occur within hours. The double rim or halo on radiograph distinguishes a battery from a coin. Observation, honey, or inducing vomiting all allow progressive tissue injury and are contraindicated.
Reference: Nelson Textbook of Pediatrics, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.