Endoscopic removal of a button battery

Oesophageal or airway location

The definitive treatment for a button battery impacted in the oesophagus or airway is urgent endoscopic removal of the battery and evaluation for injury.

Do not delay referral for endoscopy because life-threatening perforation or haemorrhage can manifest within 2 hours of impaction. Postpone further radiological investigation to evaluate the extent of injury until after the battery has been removed.

Gastric location

Urgent endoscopic removal of the battery and evaluation for injury is indicated in any patient with pain, nausea, vomiting or haematemesis due to a button battery in the stomach.

Endoscopic removal is not required in asymptomatic patients, except children younger than 6 years who have ingested a battery more than 15 mm diameter that remains in the stomach for 4 days or more.

Intestinal location

Button batteries that have cleared the stomach usually pass through the gastrointestinal tract within 1 week. A longer transit time is more common in patients older than 65 years.

Intervention is not indicated for button batteries in the intestine unless there are complications. Perform follow-up X-rays if the battery does not emerge within 2 weeks of ingestion. If the battery is seen in the intestine on X-ray at this stage, further evaluation is required to diagnose intestinal abnormality (eg anatomical abnormality such as a stricture, intestinal dysmotility). Surgical removal of the battery may be required if haemorrhage or intestinal perforation occur, but this is rare.

Other locations

Button batteries inserted into the ear, nose, vagina or rectum require urgent surgical removal.