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Case Reports
. 2025 Nov 14;2025(11):rjaf901.
doi: 10.1093/jscr/rjaf901. eCollection 2025 Nov.

Beyond childhood curiosity: foreign body ingestion as a diagnostic blind spot in adolescent small bowel obstruction-a single-center case series and review of the literature

Abdullah S Al-Darwish  1   2 , Muath Alasheikh  1 , Hamad S AlSaeed  1 , Eyad A Hijan  1 , Mohamed S Essa  1   3 , Muhaid ALNujaidi  1 , Muath AlRashed  1
Affiliations
Case Reports

Beyond childhood curiosity: foreign body ingestion as a diagnostic blind spot in adolescent small bowel obstruction-a single-center case series and review of the literature

Abdullah S Al-Darwish et al. J Surg Case Rep. .

Abstract

Foreign body ingestion (FBI) is well recognized in young children but less frequently reported in adolescents, particularly those with intellectual disability, autism spectrum disorder, or behavioral challenges. This group is at increased risk for intentional or impulsive ingestion, often resulting in delayed diagnosis and morbidity. We describe three adolescents with distal bowel complications following FBI. Case 1: a 14-year-old boy with intellectual disability developed small bowel obstruction after ingesting a plastic doll part, requiring laparotomy. Case 2: a 16-year-old boy with behavioral difficulties ingested a plastic bag fragment causing ileal obstruction, managed by enterotomy. Case 3: a 22-year-old woman with untreated mood dysregulation ingested a 4-cm nail that passed spontaneously under conservative management. FBI in this population may present as unexplained obstruction. Radiolucent plastics are often missed on plain radiography, whereas linear metallic objects may pass safely. Early computed tomography, timely surgical intervention, and psychiatric support are essential for improved outcomes.

Keywords: adolescent; behavioral disorders; bowel obstruction; foreign body ingestion; intellectual disability; psychiatry; surgery.

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Conflict of interest statement

None declared.

Figures

Figure 1
Figure 1
Intraoperative photograph showing the plastic doll just after extraction.
Figure 2
Figure 2
Intraoperative photograph of the retrieved folded plastic bag causing distal ileal obstruction.
Figure 3
Figure 3
CT abdomen revealed the metallic nail in the cecum.
See this image and copyright information in PMC

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