Urgent X-Rays in Children With Unexplained Haematemesis Help Rule Out Button Battery Ingestion.

Abstract

Aim: The ingestion of foreign bodies, particularly button batteries, is a significant concern in paediatric care, especially in children under 4 years of age. This study aims to review unwitnessed button battery ingestion in infants and toddlers, considering the serious complications and the higher risk in children under 2 years old.

Method: A literature review was conducted on studies published between 1983 and 2025 using the terms 'disk battery', 'button battery', 'ingestion', and 'unwitnessed'. Fifteen studies were included, reporting a total of 41 cases of unwitnessed button battery ingestion.

Results: The median age of patients was 18 months. Common symptoms included dysphagia, vomiting, fever, drooling and hematemesis. The average time to presentation at the emergency department was 72 h. Diagnostic delays were often due to initial misidentification of the battery as a coin. Radiographic imaging of the chest and abdomen identified the battery in 92% of cases, highlighting the diagnostic value of X-rays.

Conclusion: Prompt chest and abdominal X-rays are recommended for children under 4 years presenting with unexplained hematemesis to rapidly identify button battery ingestion, minimise diagnostic delays and improve clinical outcomes.