“The Itsy-Bitsy Water Bead Went Down the Baby's Mouth. Will Drinking Gastrografin Help to Flush It Out?”

Abstract

IntroductionForeign body ingestion is a common occurrence in the pediatric population. Superabsorbent polymers (i.e., water beads [WB]), such as Orbeez, are brightly colored spheres, can expand up to 100x their original size and are marketed as toys for kids. Ingested WB may lead to a bowel obstruction and typically require surgical removal. MethodsFully expanded WBs (N = 15) were placed into 1 of the 3 solutions: water (N = 5), gastrografin (N = 5), or 1:1 mixture of gg and water (N = 5), with serial diameter measurements obtained at 1, 4, 8, and 24 h. Additionally, fully expanded WBs were placed into succus containing post mortem porcine small bowel and mixed with gastrografin (N = 10) or nothing (N = 10), with diameters measured prior to placement and at 4 h. ResultsAt all time points, the mean WB diameter of the gastrografin arm was significantly smaller than the other two arms (P < 0.01). WBs submerged in gastrografin saw a 58% reduction in diameter at 4 h compared to 45% reduction in the 1:1 mixture and a 2% growth in water (P < 0.01). When placed into small bowel containing gastrografin, the mean WB diameter decreased by 47% at 4 h versus 37% in the control arm (P < 0.01). ConclusionsGastrografin significantly reduced the size of WB in both the in-vitro and ex-vivo post mortem animal study; and it may offer a nonsurgical option for the management of water bead ingestion. Studies assessing the clinical efficacy of a gastrografin nonoperative management strategy are needed.