Button battery ingestion (BBI) in children can lead to lifethreatening complications including death. In 2021, the EuropeanSociety for Pediatric Gastroenterology Hepatology and Nutrition(ESPGHAN) published guidance, aiming to unify the managementfor better outcomes and to assess the compliance to EPSGHAN guidance and the impact ofthis problem in our community including the long termcomplications.

Retrospective data collection looking at all pediatric patient whopresented with button battery ingestion in our children’s hospitalfrom 2018 – 2023.

From April 2018 till November 2024, 40 patients presented with BBI. In our datanoticed increase in number of cases per year, in 2022 we had 18 patients(Fig.1.A). The button battery mainly was in esophagus (52%, n=21), and 37%(n=15) were in stomach. ESPGHAN recommends removing button battery inesophagus within 2 hours. 14 patients who met the criteria, underwentendoscopy removal within average of 1.5 hours. According to endoscopicclassification of corrosive injuries (Zargar classification) 9 patients had 0 score,but 14 had class IIIa (Fig.1B) . 82% (n=33) of patients recovered fully, 3 patientshad short term complications: fever, and one had esophageal perforation .3patients had long term complications including esophageal stricture requiringmultiple dilatations and tracheoesophageal fistula and one died (Fig.1.C).Out of 32 patients who presented <12h , 14 received honey in emergencydepartment. 15 patients met the indications for further imaging, but13 of themhad either CT or MRI done during the admission.In 18 patients who underwent endoscopic removal of button battery inesophagus, 13 patients had acetic acid irrigation during endoscopy (Fig.1.D).

Overall, the majority of patients after 2021 received management as perESPGHAN guidance, most of the patients recovered but the long termcomplications can be life threatening and cause significant morbidity andmortality.