• foreign body
• intussusception

A 5 year old girl underwent laparotomy for small bowel obstruction. She had been unwell for several days but there was no other significant history. Abdominal x ray examination confirmed high intestinal obstruction but no cause could be identified.

At operation an ingested squeezable bulb from a toy (inset) was found to be inducing intussussception into itself, preventing further forward movement (main picture). Most swallowed foreign bodies will pass through the bowel, although perforation from needles is possible. Intussussception is more unusual but has been reported where objects are made from deformable materials. Furthermore, imaging is made difficult by the radiolucency of objects showing only the level of the obstruction. The possibility of bolus obstruction should be remembered, especially in childhood where there may be no history of ingestion.