Unrecognized foreign bodies in the gastrointestinal tract of developmentally delayed children: A case series

•Foreign body ingestion is often a difficult diagnosis in the pediatric population.•Most objects pass spontaneously through the gastrointestinal system without harm.•Endoscopy can be used for retrieval of objects in the upper gastrointestinal tract.•Surgery is reserved for complications of ingestion or objects that pose serious harm.•Techniques combining laparoscopy and endoscopy may be of benefit to select patients.

Foreign body ingestion is very common in the pediatric population. Children with developmental delay are at an increased risk of foreign body ingestion for several reasons, including poor gross and fine motor control, prolonged oral phase, oral and pharyngeal dysphagia, impaired protective mechanisms, and difficulty communicating. Four patients between the ages of 3 and 18 years old with developmental delay presented with nonspecific gastrointestinal and pulmonary symptoms. Foreign bodies along the upper gastrointestinal tract were identified as the cause of these symptoms, and all four patients improved after endoscopic retrieval. A high index of suspicion should be had even in the absence of findings on routine imaging. Once symptoms are displayed, clinicians should aim to endoscopically or surgically remove the foreign body, depending on the location along the gastrointestinal tract.