To Intervene or Observe: Accidental Ingestion of a Wireless Earbud in an Adult

Foreign body ingestion in adults, particularly an electronic device containing a lithium-based battery, remains a challenging emergency department (ED) presentation, due to limited literature and specific guidelines. Management decisions depend on object characteristics, anatomical location, and symptomatology. We report the unusual case of an alert, 22-year-old female who accidentally ingested a single wireless earbud. On presentation to the ED within an hour of ingestion, she remained asymptomatic with stable vital signs throughout evaluation. An initial erect abdominal radiograph localized the foreign body to the second part of the duodenum. Following multidisciplinary discussion, a conservative "wait-and-watch" approach was adopted. Serial abdominal radiographs demonstrated gradual distal migration, confirming spontaneous passage of the device on day five. This case highlights the importance of individualized risk assessment and underscores the role of conservative management with close radiologic monitoring in selected asymptomatic patients, even when the ingested object is an electronic device containing a sealed lithium-ion battery.