Orbezoar: A Superabsorbent Polymer Causing Small Bowel Obstruction in a Toddler.

Abstract

Foreign body ingestions are not uncommon in children between 6 months and 3 years. The majority are managed conservatively and <1% necessitate surgery (1,2). Superabsorbent polymers are materials, which retain a substantial amount of liquid allowing them to expand considerably (3). As such, toys made of these materials pose a serious risk if ingested and the majority have been recalled (4). Orbeez (Maya Toys, Cypress, CA), a superbsorbent polymer bead product, is marketed for children and studies have suggested that ingestion is unlikely to cause clinically significant intestinal obstruction (5,6). We report the case of a 19-month-old girl who presented with emesis and fussiness following ingestion of Orbeez beads. Given the persistence of obstructive symptoms, she underwent a diagnostic laparoscopy, which demonstrated multiple dilated loops of small bowel and a clear transition point in the mid-jejunum. This segment of the bowel was externalized (Fig. 1). A 3 cm Orbeez bead and multiple small fragments were extracted from a transverse enterotomy (Fig. 2). The patient subsequently did well.FIGURE 1: Mid-jejunal bowel with focal area of obstruction (arrow) resulting in proximal small bowel dilation.FIGURE 2: Transverse enterotomy with subsequent removal of 3 cm superabsorbent polymer (Orbeez) foreign body.Despite previous reports suggesting that Orbeez is safe, this first report of ingestion necessitating surgical exploration highlights the need for heightened awareness when exposure to superabsorbent polymer is suspected.