Radiographic corrosion and clinical outcomes in pediatric esophageal button battery impaction: a retrospective reproducibility study.

PURPOSE: Radiographic corrosion of impacted esophageal button batteries has recently been proposed as a potential predictor of severe injury. We aimed to reproduce these findings and evaluate the association between radiographic corrosion and clinical outcomes in a pediatric population treated at a tertiary referral center. METHODS: We conducted a retrospective analysis of children under 13 years of age admitted for esophageal button battery impaction between January 2022 and December 2024. All patients underwent repeat anteroposterior and lateral chest radiography on admission. Corrosion was graded according to a previously published classification (none, 0%; moderate, 1–50%; severe, 51–100% of battery perimeter involvement). Radiographs were independently reviewed by two senior clinicians blinded to outcomes. Intraoperative findings and complications were recorded. Associations were assessed using Fisher’s exact test and the Mann–Whitney U test. RESULTS: Eleven patients were included (median age 16 months). Radiographic corrosion was identified in 5/11 cases (45.5%). Five patients developed complications, including three major events. No significant association was found between radiographic corrosion and overall complications (p = 0.57) or between corrosion grade and complications (p = 0.69). However, corrosion was significantly associated with lower intraoperative severity scores (p < 0.05). CONCLUSION: In our cohort, radiographic corrosion was not associated with an increased risk of complications and did not reproduce previously reported findings. Larger multicenter studies are required to clarify the role of radiographic features in risk stratification and to support management decisions, particularly in resource-limited settings.