Beyond childhood curiosity: foreign body ingestion as a diagnostic blind spot in adolescent small bowel obstruction—a single-center case series and review of the literature

Foreign body ingestion (FBI) is well recognized in young children but less frequently reported in adolescents, particularly those with intellectual disability, autism spectrum disorder, or behavioral challenges. This group is at increased risk for intentional or impulsive ingestion, often resulting in delayed diagnosis and morbidity. We describe three adolescents with distal bowel complications following FBI. Case 1: a 14-year-old boy with intellectual disability developed small bowel obstruction after ingesting a plastic doll part, requiring laparotomy. Case 2: a 16-year-old boy with behavioral difficulties ingested a plastic bag fragment causing ileal obstruction, managed by enterotomy. Case 3: a 22-year-old woman with untreated mood dysregulation ingested a 4-cm nail that passed spontaneously under conservative management. FBI in this population may present as unexplained obstruction. Radiolucent plastics are often missed on plain radiography, whereas linear metallic objects may pass safely. Early computed tomography, timely surgical intervention, and psychiatric support are essential for improved outcomes.