Water-beads Ingestion with Intestinal Obstruction in Children: A Case Report

Authors

  • Nicodemus Pediatric Intensive Care Unit, Mayapada Hospital Jakarta Selatan, Jakarta, Indonesia
  • Nuraini Irma Susanti Pediatric Gastroenterologist, Mayapada Hospital Jakarta Selatan, Jakarta, Indonesia

DOI:

https://doi.org/10.58427/apghn.3.1.2024.24-32

Keywords:

children, foreign body ingestion, intestinal obstruction, water beads

Abstract

Background: Foreign body ingestion often occurs in the pediatric population and can cause no symptoms or even cause complications due to swallowing the foreign body. The aim of this case report is to increase clinician knowledge of cases of foreign body ingestion which can cause complications.

Case: We report a case of foreign body ingestion water beads with complications of intestinal obstruction in a 1 year 2-month-old girl. The patient came with complaints of vomiting more than ten times containing fluid accompanied by decreased intake. The patient was suspected of swallowing water beads. The patient came to the emergency room with no signs of acute abdomen and the results of plain abdominal radiograph showed no foreign objects. The patient began to show symptoms of obstruction, not being able to defecate and not being able to pass gas. Physical examination revealed abdominal distention accompanied by inaudible bowel sounds. Abdominal CT scan results showed ileal obstruction. An exploratory laparotomy was performed, and two water beads were found intraoperative, which were the cause of the obstruction. The foreign body was removed. After surgery, the patient experienced gradual clinical improvement until he was discharged ten days after the procedure.

Discussion: Foreign body ingestion in children is often not witnessed by anyone and may not cause symptoms until complications such as obstruction or peritonitis occur. Some foreign objects are radiolucent in plain radiographs. In emergency cases of foreign body ingestion, it is necessary to carry out emergency endoscopic procedures, even emergency surgical procedures in cases that cause complications.

Conclusion: This case report increases clinician knowledge and awareness regarding the clinical approach in evaluating patients with suspected foreign body ingestion in children.

References

Wright CC, Closson FT. Updates in pediatric gastrointestinal foreign bodies. Pediatr Clin North Am. 2013;60(5):1221-39.https://doi.org/10.1016/j.pcl.2013.06.007 DOI: https://doi.org/10.1016/j.pcl.2013.06.007

Wyllie R. Foreign bodies in the gastrointestinal tract. Curr Opin Pediatr. 2006;18(5):563-4.https://doi.org/10.1097/01.mop.0000245359.13949.1c DOI: https://doi.org/10.1097/01.mop.0000245359.13949.1c

Jayachandra S, Eslick GD. A systematic review of paediatric foreign body ingestion: presentation, complications, and management. Int J Pediatr Otorhinolaryngol. 2013;77:311–7.https://doi.org/10.1016/j.ijporl.2012.11.025 DOI: https://doi.org/10.1016/j.ijporl.2012.11.025

Krom H, Visser M, Hulst JM, Wolters VM, Van den Neucker AM, de Meij T, et al. Serious complications after button battery ingestion in children. Eur J Pediatr. 2018;77(7):1063-70.https://doi.org/10.1007/s00431-018-3154-6 DOI: https://doi.org/10.1007/s00431-018-3154-6

Lee JH. Foregin body ingestion in children. Clin Endosc. 2018;51(2):129-36.https://doi.org/10.5946/ce.2018.039 DOI: https://doi.org/10.5946/ce.2018.039

Taylor JE, Campbell M, Daley B. The management of small bowel obstruction caused by ingested gastrostomy tube. Am Surg.2019;85(8):e372-3.https://doi.org/10.1177/000313481908500802 DOI: https://doi.org/10.1177/000313481908500802

Taylor JE, Clegg D. Foreign bodies and bowel obstruction [Internet]. IntechOpen; 2020 [cited 2023 Jan 10]. Available from:https://doi.org/10.5772/intechopen.92170 DOI: https://doi.org/10.5772/intechopen.92170

Lee NR, Shin HB, Jeong YJ, Kim SJ. Small bowel obstruction by water beads in a 12-month-old girl presenting with acute hyponatremia with seizure. Pediatr Emerg Med J 2019;6:86-91.https://doi.org/10.22470/pemj.2019.00115 DOI: https://doi.org/10.22470/pemj.2019.00115

Kramer RE, Lerner DG, Lin T, Manfredi M, Shah M, Stephen TC, et al. Management of ingested foreign bodies in children: a clinical report of the NASPGHAN Endoscopy Committee. J Pediatr Gastroenterol Nutr. 2015;60(4):562-74.https://doi.org/10.1097/MPG.0000000000000729 DOI: https://doi.org/10.1097/MPG.0000000000000729

Zamora IJ, Vu LT, Larimer EL, Olutoye OO. Water-absorbing balls: a “growing” problem. Pediatrics. 2012;130:e1011-4.https://doi.org/10.1542/peds.2011-3685 DOI: https://doi.org/10.1542/peds.2011-3685

Darracq MA, Cullen J, Rentmeester L, Cantrell FL, Ly BT. Orbeez: the magic water absorbing bead--risk of pediatric bowel obstruction? Pediatr Emerg Care. 2015;31:416-8.https://doi.org/10.1097/PEC.0000000000000304 DOI: https://doi.org/10.1097/PEC.0000000000000304

Mirza B, Sheikh A. Mortality in a case of crystal gel ball ingestion: an alert for parents. APSP J Case Rep. 2012;3(1):6.

Lim CW, Park MH, Do HJ, Yeom JS, Park JS, Park ES, et al. Factors associated with removal of impactted fishbone in children, suspected ingestion. Pediatr Gastroenterol Hepatol Nutr. 2016;19(3):168-74.https://doi.org/10.5223/pghn.2016.19.3.168 DOI: https://doi.org/10.5223/pghn.2016.19.3.168

Wnęk B, Łożyńska-Nelke A, Karoń J. Foreign body in the gastrointestinal tract leading to small bowel obstruction—case report and literature review. Pol Przegl Chir. 2015;86(12):594-7.https://doi.org/10.1515/pjs-2015-0006 DOI: https://doi.org/10.1515/pjs-2015-0006

Care W, Dufayet L, Paret N, Manel J, Laborde-Casterot H, Blanc-Brisset I, et al. Bowel obstruction following ingestion of superabsorbent polymers beads: literature review. Clin Toxicol. 2022;60(2):159-67.https://doi.org/10.1080/15563650.2021.1987452 DOI: https://doi.org/10.1080/15563650.2021.1987452

Mohamed A, Quora H, Alshuili, Karim M, Abushosha A, Abdulsattar N, et al. Bowel obstruction by ingestion of superabsorbent polymer balls. J Pediatric Surg Case Rep. 2019;41:27-9.https://doi.org/10.1016/j.epsc.2018.11.005. DOI: https://doi.org/10.1016/j.epsc.2018.11.005

Published

2024-02-29

How to Cite

1.
Water-beads Ingestion with Intestinal Obstruction in Children: A Case Report. Arch Pediatr Gastr Hepatol Nutr [Internet]. 2024 Feb. 29 [cited 2024 Apr. 23];3(1):24-32. Available from: https://apghn.com/index.php/journal/article/view/50