Intestinal Obstruction and Neurotoxicity Associated With Water Bead Ingestion

Water beads are superabsorbent polymer balls. They were originally marketed for agricultural and decorative applications and are now sold as sensory toys. They can be harmful to children in 2 ways. Upon ingestion, water beads absorb liquid and, because they can increase in volume by more than a hundredfold, intestinal obstruction can result. In addition, they are made of polymerized acrylamide monomer. Acrylamide monomer can be toxic at high levels. Here, we present a case of intestinal obstruction in the setting of water bead ingestion temporarily associated with signs of neurotoxicity. The patient presented to the emergency department at 13 months of age with vomiting, lethargy, weight loss over several weeks, insomnia, and facial dermatitis. Due to worsening clinical signs and imaging findings suggestive of intestinal obstruction, she underwent an exploratory laparotomy. A mass consisting of water beads was removed from the distal small intestine. After removal of the mass, the patient's facial dermatitis resolved; however, the patient's speech, gross and fine motor, sensory, and neurological functions continued to worsen. After reevaluation, a second surgical procedure led to removal of multiple fragments of water bead material from the patient's large intestine. This case highlights the potential dangers of acrylamide in consumer products that may be accessible to children.