Radiolucent Plastic Food Pick Ingestion in a Child: Endoscopic Retrieval Despite Negative CT Findings

Foreign body ingestion is a common pediatric emergency, and plastic objects are particularly difficult to detect on imaging due to their radiolucency. This can lead to delayed diagnosis and serious complications, especially when the ingestion is unwitnessed or the child is asymptomatic. We report a case of a four years and five months old girl who claimed to have accidentally swallowed a 4.6 cm tapered plastic food pick. She was asymptomatic on initial presentation, and neither X-rays nor CT scans revealed the foreign body. She was initially discharged. However, upon reevaluation of the history and characteristics of the object, a senior physician suspected the presence of a retained elongated object and advised re-presentation. Under general anesthesia, upper gastrointestinal endoscopy was performed, and the pick was safely retrieved from the stomach without complications. This case highlights the clinical significance of recognizing the potential danger posed by radiolucent, tapered plastic foreign bodies, even in asymptomatic patients. Clinical decisions should not rely solely on imaging but incorporate the history and nature of the object. This case emphasizes the importance of flexible clinical judgment and early intervention in managing radiolucent foreign body ingestion.