Diagnosis: button battery up the nasopharynx. Button batteries can cause devastating caustic injury to the nasal cavity and sinuses. Careful examination and x-ray/CT are critical when evaluating the possibility of this foreign body. Strong index of suspicion is necessary for toddlers presenting with unexplained bloody nose and irritability, as this can often be the only sign in this age group.
Acknowledgement: Case presented by Nahum Kovalski, BSc, MDCM, Terem Emergency Medical Centers, Jerusalem, Israel.