Surgeons remove rubber ball from teen's intestines

Shaare Zedek's surgeons performed a laparoscopy, and removed a ping-pong-sized object that swelled and endangered the 14-year-old boy's life.

 The rubber ball obstructing a teenager's intestines. (photo credit: SHAARE ZEDEK MEDICAL CENTER)
The rubber ball obstructing a teenager's intestines.
(photo credit: SHAARE ZEDEK MEDICAL CENTER)

Emergency-room physicians are accustomed to seeing babies and toddlers who have swallowed foreign objects and need emergency treatment – but not teenagers.

“One must be aware of the dangers involved in swallowing a foreign body, especially since it is made of such a flexible material that may disrupt the function of the convoluted abdominal organs.”

Dr. Giora Weiser

A month-long process

Doctors at Jerusalem’s Shaare Zedek Medical Center recently admitted N., 14, from Shilo in the Binyamin region, who accidentally gulped down a small orange, rubber object attached to the end of a pencil. About a month ago, while playing with his friend at school, he grabbed a pencil with the ball and put it in his mouth. It swelled in his stomach into the size of a ping-pong ball, moved to his intestines and clogged them, endangering his life.

Because no inconvenience was caused, N. did not attach much importance to the event. But several days after he swallowed the foreign object, he complained of severe abdominal pain and nonstop vomiting. The boy’s parents contacted their family physician, who referred them to Shaare Zedek’s Emergency Medicine Department, headed by Dr. Giora Weiser. They took him to the hospital, where surgeons suspected a dangerous intestinal obstruction. He was admitted for urgent surgery, at the end of which the surgeons pulled out the bouncing ball.

Dangers of swallowing objects

“One must be aware of the dangers involved in swallowing a foreign body, especially since it is made of such a flexible material that may disrupt the function of the convoluted abdominal organs,” Weiser said.

Dr. Aner Keinan, a senior pediatric surgeon, treated the youth.

Dr. Ofra Carmel of the Pediatric Surgery Department said this was a very rare event of such a significant blockage caused by a foreign object in a teenager. The imaging tests did not clearly show what the foreign object was, as it had turned inside out.

“We did not think it was a tumor, but there was certainly a reasonable suspicion of a secondary obstruction caused by inflammation or a foreign object,” she said.

L to R: Dr. Aner Keinan, Dr. Yaron Armon and Dr. Giora Weiser. (credit: SHAARE ZEDEK MEDICAL CENTER)L to R: Dr. Aner Keinan, Dr. Yaron Armon and Dr. Giora Weiser. (credit: SHAARE ZEDEK MEDICAL CENTER)

Within an hour of diagnosis, N. was admitted for urgent surgery, during which a tiny incision two or three centimeters long was made for a laparoscopic (keyhole) approach. Through the small incision in the intestine, they removed a lump of rubber that had absorbed fluids and swelled. They closed the gut and informed the parents, who were happy to find out that the cause of the blockage was just a ball of rubber.

A full recovery

N. was hospitalized for further supervision in the Pediatric Surgery Department, headed by Dr. Yaron Armon, for recovery. After a few days, he was able to eat without difficulty. N. is now at home and is expected to recover fully.

Weiser said it was a rare case because time had passed between the swallowing incident and the symptoms. He urged children of all ages not to put foreign objects in their mouth because of the danger of swallowing them, especially those made of flexible materials that cam disrupt the function of the twisted abdominal organs.