The scenario structure was developed from the clinical problem and iteratively refined through claim-by-claim review of current guidelines and published literature. Each clinically consequential statement was assigned an evidence label according to the level of direct support identified. Where direct supporting evidence was not identified, the statement was explicitly labelled as indirect evidence or authors’ clinical synthesis.
Four levels, applied to each clinically consequential statement, describing how directly the published sources support it. They are a reading aid for evaluating the literature, not an instruction on how much weight to give a statement in practice, and they do not constitute a formal hierarchy of evidence quality.
The content is reviewed at least annually against current guidelines from NASPGHAN, ESPGHAN and relevant ACR Appropriateness Criteria, and may be revised earlier when new evidence or guidance is identified that could materially affect the pathway.
Each release is deposited under the same DOI, which always resolves to the most recent version. A copy of this file that has been emailed or printed may be out of date: the version and review date above are the only reliable check.
¹Unit of Pediatric Surgery, Azienda Ospedaliero-Universitaria Ospedali Riuniti di
Ancona, Salesi Children’s Hospital, Ancona, Italy
²Department of Specialized Clinical and Odontostomatological Sciences, Marche
Polytechnic University (UNIVPM)
³Anesthesia and Intensive Care Unit, Azienda Ospedaliero-Universitaria Ospedali
Riuniti di Ancona, Salesi Children’s Hospital, Ancona, Italy
⁴Department of Radiological Sciences, Azienda Ospedaliero-Universitaria Ospedali
Riuniti di Ancona, Salesi Children’s Hospital, Ancona, Italy
⁵Department of Paediatrics, Marche Polytechnic University, Salesi Children’s Hospital, Ancona, Italy
Pierangeli F, Cruccetti A, Nino F, Bindi E, Prendushi N, Amici L, Brusco M, Gatti S, Lionetti ME, Cobellis G. Button Battery Ingestion — An Educational Reference Resource. Version 23.4 2026. doi:10.17605/OSF.IO/UTS7N
Cite this work as a publication. It is not a clinical protocol and carries no institutional endorsement.
A claim-by-claim review of the evidence on paediatric button battery ingestion, organised by clinical scenario. To be read alongside local protocols and current guidelines.
Every clinically consequential statement is explicitly linked to its underlying level of evidence.
Method, the citation audit and the full bibliography are in the Evidence & method tab.