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The parents of a 1-year-old child bring him to your office because 30 minutes ago he swallowed an 11.5-mm button battery which his grandmother dropped while changing the batteries in her hearing aid. The child seems fine when you examine him.

Which one of the following is the most appropriate advice?



1)Vomiting should be induced immediately with syrup of ipecac
2)A radiograph should be obtained immediately to see if the battery is lodged in the esophagus
3)If the battery does not appear in the child's stool within 48 hours, a roentgenogram of the abdomen should be performed to see if the battery has passed from the stomach
4)All ingested batteries should be retrieved, endoscopically if necessary, because electric current or chemicals leaking from the battery are likely to injure the gastrointestinal tract
5)No medical attention is needed unless the child experiences symptoms such as vomiting, abdominal pain, diarrhea, anorexia, or dysphagia

2.

4..

2)A radiograph should be obtained immediately to see if the battery is lodged in the esophagus

4..

Early intervention is indicated for patients who have swallowed button or disc batteries because of the potential for voltage burns and direct corrosive effects. Burns can occur as early as four hours after ingestion. Button batteries that remain in the stomach for more than 48 hours or that are larger than 2 cm in diameter should be removed endoscopically. Once they are past the duodenal sweep, 85 percent of button batteries pass in less than 72 hours. Radiographs should be obtained every three to four days to follow the progress of the battery until it has been passed.

from what I know lye or battery first do X-ray if impacted in esophagus than do endoscopy if it crossed the duodenum just follow up till it comes out. so the first step I would still think is xray 2 ...... plz correct me or post any comments.

sami, ajeet
like you folks i too picked 4 but the answer is 2 accoring to the source

i gotit, the flaw with 4 is that if the battery has crrosed the duodenum, it will come out in 72 hrs. So no need for aggresive approach.