Extensive Esophageal Necrosis Following Button Battery Ingestion

Button battery ingestion is a medical emergency in young children and may cause rapid and severe esophageal injury within a short exposure time. We report a 3-year-old girl who presented to the pediatric emergency department 1 hour after ingesting a button battery from a tablet device. Despite pre-endoscopic administration of sucralfate and urgent endoscopic removal performed within 2 hours of admission, extensive multifocal deep esophageal necrosis was detected at the site of impaction. The battery was successfully removed, and the patient was managed with close monitoring, temporary cessation of oral intake, intravenous proton pump inhibitor therapy, and gradual reintroduction of feeding with prolonged liquid nutrition. Follow-up endoscopy at 1 month demonstrated marked mucosal healing with fibrotic retraction. This case highlights that significant esophageal injury may develop rapidly even with prompt guideline-based management, emphasizing the need for immediate recognition, urgent endoscopic intervention, and careful post-removal follow-up in children with button battery ingestion.