Our Case Report Associate Editor Dr. Jeff Malatack shares with us his excitement learned from a case report we are early releasing this month from our upcoming issue: Water absorbing balls are tiny, at times brightly colored spheres with the capacity to absorb relative large volumes of water and in so doing expand significantly in size. Zamora et al. (doi: 10.1542/peds.2011-3685) working at Texas Children’s Hospital and Baylor University College of Medicine bring to our attention a case of ingestion of such a sphere swallowed (1.1cm diameter when ingested) by an eight month old. The ball apparently remained small enough to pass through the pylorus only to obstruct the infants small bowel as it enlarged in the small bowel’s liquid environment. The general assumption is that if a foreign body is small enough to get out of the stomach then it is small enough to transit the bowel and exit the anus doesn’t apply to the balls that enlarge in transit. The child required surgery to remove the enlarged ball and relieve the obstruction. Zamora et al. subsequently experimented with the balls ex- vivo and found disturbing information regarding the size magnification possible over 96 hours (5 times initial diameter) but that in the first few hours enlargement is slow enough for the balls to pass out of the stomach. Watch out for infants and young children with bowel obstruction as these balls are finding their way into infant toys.
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