S4540 Listen to Your Gut: A Case Report Highlighting the Risk of Caustic Injuries From Ingestion of Wearable Technologies

Introduction: Lithium-ion batteries are the battery of choice for wearable technologies for their compact size with powerful charge. Due to its popularity in technology, caustic injuries secondary to lithium ingestion continue to be a major problem with 855 lithium battery ingestions reported to the National Poison Data System in 2023. This case report discusses the importance of considering the internal components of wearable technologies when managing foreign body ingestions. Case Description/Methods: A 28-year-old man with history of autism spectrum disorder, recurrent suicidal ideations, and schizoaffective disorder with command auditory hallucinations presented overnight after swallowing reported Bluetooth earbuds. He previously underwent ileostomy, partial colectomy, and reversal anastomosis after ingesting batteries. On presentation, he was endorsing epigastric and left upper quadrant pain. Initial abdominal x-ray showed mobile radio-opaque foreign bodies in the gastric lumen. Repeat abdominal x-ray 5 hours later showed the foreign bodies with a possible wire connection in mid-abdomen. Urgent enteroscopy the next day did not show any foreign bodies in the stomach, duodenum or proximal jejunum. Patient endorsed worsening umbilical abdominal pain. Computed tomography Abdomen and Pelvis the same evening showed 2 metallic ovoid structures at the transverse and proximal descending colon respectively. Flexible sigmoidoscopy was performed the following day and found 1 earbud covered in stool with exposed wires, another earbud covered in stool with approximately 5 cm wire attached, and wire fragments which were all retrieved. Discussion: Caustic injuries from ingestion of lithium batteries are well-documented in literature; however, wearable technologies are becoming increasingly popular. This includes smart rings, earrings, watches, glasses, and Bluetooth earbuds which are small enough to ingest and include lithium batteries. Prompt recognition of wearable technologies when managing foreign body ingestions is important to prevent delays in appropriate interventions and avoid potential complications.