When toys become dangerous: small bowel obstruction from water-absorbing bead ingestion in children-a case series.

Bowel obstruction caused by ingestion of water-absorbing beads is an increasingly recognized pediatric emergency. We report four cases in children under 5 years of age presenting with bilious vomiting and absence of bowel movements. Plain radiographs demonstrated features of small bowel obstruction without visualization of the foreign body, while ultrasound revealed cystic intraluminal lesions suggestive of obstruction. Surgical exploration confirmed expanded beads causing complete intestinal obstruction at different levels of the small intestine. Enterotomy with foreign body removal and bowel repair was performed in all patients, with uneventful recovery. No additional beads were identified intraoperatively, and no recurrent bowel obstruction was observed during at least 3 months of follow-up. Water-absorbing beads pose a unique diagnostic challenge because they are radiolucent and may mimic gastroenteritis. Their ability to expand after passing the pylorus can result in delayed complete obstruction. Early recognition and timely surgical intervention are essential to prevent serious complications.