A Killer in Disguise: Button Battery Ingestions in Acute Care.

Ingestion of button batteries (BB) represents a substantial health hazard, causing more common and severe complications than most other ingested objects. While the primary mechanism of injury is alkaline caustic injury (mediated by hydroxide ions produced through electrolysis at the site of the button battery), additional pathophysiological processes include pressure-induced necrosis, accumulation of hydroxide compounds at the battery's negative pole, direct caustic tissue injury, and potential heavy metal toxicity. Full-thickness burns, esophageal perforation, tracheoesophageal and aortoesophageal fistulas are encountered shortly after exposure. Vocal cord paralysis due to BB ingestion appears to be an early sign to predict the severity of the condition. Besides expedient removal, mitigation strategies are the key to the management. Pre-BB removal using honey or sucralfate and post-removal sterile acetic acid irrigation in the operation room can alleviate complication rates. This review is intended to cover and summarize all aspects of these incidents to provide information to clinicians and healthcare personnel.