The Foreign Body That Wasn’t

A 5-year-old nonverbal male with autism spectrum disorder and congenital fourth nerve palsy presented with acute distress, restlessness, and recurrent vomiting. His mother reported he suddenly “did not look right,” and appeared uncomfortable. Earlier, he was evaluated at an outside emergency department, received ceftriaxone for otitis media, and was discharged. Symptoms persisted with multiple episodes of emesis. On arrival, he was afebrile and hemodynamically stable. Physical examination was limited by developmental status and revealed no peritoneal findings.