Massive ingestion of water-absorbent polymer beads in an adult requiring surgical management.

Background: The incidence of intentional foreign body ingestion is rising in the UK, with water-absorbent polymer beads (WAPBs) increasingly implicated in children. While commonly used in horticulture and as toys, WAPBs can pose serious risks when ingested. This report details a unique case of massive WAPB ingestion in an adult, emphasizing the potential complications and management challenges.

Case report: A 60-year-old male presented with severe abdominal pain, nausea, and vomiting after ingesting an estimated 25,000 WAPBs. CT imaging showed a massive volume of WAPBs throughout the gastrointestinal (GI) tract, and free fluid around the duodenum likely due to reactive pancreatitis. An emergency laparotomy was performed due to the risk of impending perforation. At laparotomy, a gastrostomy and 2 enterotomies were made to remove as many WAPBs as possible. A loop ileostomy was formed due to ongoing retention of the beads and risk of obstruction. Post-operatively, the patient was placed on total parenteral nutrition and the remaining WAPBs passed through the ileostomy. Further imaging revealed ongoing pancreatitis and a peripancreatic collection, which was managed conservatively. The patient was discharged two months after surgery.

Discussion: This case represents the first documented instance of massive WAPB ingestion in an adult. It highlights the significant risks associated with ingesting large quantities of WAPBs, including GI obstruction and pancreatitis. Early surgical intervention was critical in preventing further complications, as endoscopic removal was impractical given the volume.

Conclusions: Massive ingestion of WAPBs poses significant health risks and may necessitate prompt surgical management. This case underscores the importance of timely intervention to prevent severe outcomes associated with large volumes of ingested WAPBs.