# Spontaneous passage of an accidentally ingested metallic bullet casing in an adolescent: a case report

## TL;DR

A 17-year-old girl accidentally swallowed a metallic bullet casing, which passed safely through her digestive system without complications.

## Contribution

This case report demonstrates the safety of conservative management for asymptomatic accidental ingestion of a foreign body in adolescents.

## Key findings

- The metallic bullet casing was spontaneously expelled without requiring invasive intervention.
- The patient remained asymptomatic and showed no complications during follow-up.
- Conservative management with monitoring is a viable option for selected cases of foreign body ingestion.

## Abstract

Accidental ingestion of foreign objects is a frequent emergency presentation that can lead to serious complications. It is most often seen in children and high-risk adults, but remains rare in healthy adolescents without predisposing factors.

We describe a 17-year-old female who accidentally swallowed a metallic bullet casing during a meal. She presented two hours later with only a mild sore throat. Serial abdominal radiographs demonstrated progressive passage of the casing through the gastrointestinal tract without perforation or obstruction. With close inpatient monitoring, including clinical evaluations and sequential imaging, the casing was spontaneously expelled per rectum. The patient remained asymptomatic, and follow-up showed no complications.

Most blunt, small foreign bodies pass spontaneously. This case highlights that, in carefully selected asymptomatic patients, conservative management with vigilant monitoring is a safe and effective alternative to invasive intervention.

Conservative management can be both safe and effective in healthy adolescents who accidentally ingest a foreign body, provided there are no clinical or radiological signs of obstruction, perforation, or other complications.