Button batteries, commonly used in hearing aids, watches, electronic devices, toys, and even novelty clothing items, can cause significant injury to the esophagus as a result of direct current flow through tissue, local hydrolysis, and local hydroxide accumulation. The discharge state of the battery does not relate to patient outcome.69 Patients who have ingested button cell batteries should undergo radiography to determine the location of the battery. Batteries lodged in the esophagus should be removed emergently as burns may occur as early as 4 hours after ingestion and perforation as soon as 6 hours after ingestion; fatalities have been reported.
Removal should be done endoscopically to allow direct visualization. Batteries that have passed beyond the esophagus need not be retrieved unless they remain lodged in the stomach for more
than 48 hours or the patient manifests signs or symptoms of injury to the gastrointestinal tract