What to do after it's swallowed? Management strategies after superabsorbent polymer bead ingestion: A scoping review

Objectives: To conduct a scoping review of the medical literature on the evaluation, management, and consequences of superabsorbent polymer (SAP) bead ingestion in children. Methods: We performed a comprehensive search of the following: Ovid MEDLINE, Embase, PubMed, CINAHL, Web of Science. Using prespecified inclusion and exclusion criteria, three independent researchers screened 138 articles. 39 studies met criteria for further evaluation; 24 studies were included. Data were extracted and reported in adherence with the PRISMA-ScR guidelines. Results: We identified 329 studies based on search criteria. Data extraction and analysis was performed on 24 studies based on our inclusion/exclusion criteria. Two case series described a total of 131 patients who were either asymptomatic or mildly symptomatic and required no reported intervention. 22 symptomatic patients were reported in 18 case reports. Median age at ingestion was 14 months (range: 6 months-19 years) with a 1:1 male-to-female ratio. Signs and symptoms included bilious vomiting, abdominal pain, distension, dehydration, and jaundice. At least one diagnostic imaging modality was utilized with abdominal plain films being the most frequent. Of symptomatic patients, 82 % required surgery for definitive management with a complication rate of 14 % and 1 mortality. Conclusion: While many patients who ingested SAP remained asymptomatic and did not require medical intervention, 82 % of symptomatic patients required surgery. The data reported in this study help highlight the dangers of SAP bead ingestion, and future studies are needed to establish standardized protocols and help guide management.