Pediatr Emerg Med J.  2023 Jan;10(1):45-48. 10.22470/pemj.2022.00535.

Usefulness of ultrasonography in diagnosis of intestinal obstruction by a water bead

  • 1Department of Pediatrics, Dankook University College of Medicine, Cheonan, Republic of Korea
  • 2Department of Radiology, Dankook University College of Medicine, Cheonan, Republic of Korea
  • 3Department of Pediatric Surgery, Dankook University College of Medicine, Cheonan, Republic of Korea


Water beads are dangerous foreign bodies causing intestinal obstruction in young children because the beads absorb water and are radiolucent. Although the features lead to progressive intestinal obstruction, it is difficult to diagnose ingestion of the beads by imaging studies. For the diagnosis, ultrasonography is safe, fast, and accurate. The imaging modality can show intestinal water beads as spherical, anechoic, smoothly demarcated cysts. This characteristic finding may be more useful in rapid and accurate diagnosis than computed tomography scan. We report a case of an 8-month-old boy who obtained a timely sonographic diagnosis of water bead-induced small bowel obstruction in the emergency department.


Cysts; Early Diagnosis; Foreign Bodies; Intestinal Obstruction; Ultrasonography


  • Fig. 1. The initial plain radiograph showing the dilated small bowel loops without gas in the colon.

  • Fig. 2. A comprehensive ultrasonogram showing a 3-cm sized, well-defined, round anechoic material in the small bowel. Dilated proximal bowel is also noted (asterisk).

  • Fig. 3. Laparotomy finding on day 1. A 3-cm sized, green, water bead (inset) was extracted from the dilated jejunum via enterotomy.

  • Fig. 4. Expansile property of a water bead, the same type with the bead in this case. The bead was proved to increase in size from 0.5 cm (inset) to 4 cm after being submerged in tap water for 12 hours.



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