Purpose or Case Report: Orbeez Water Beads, marketed as "nontoxic sensory toys for kids ages 5 and up," arrive as pinhead-sized microbeads ("seeds") which must be soaked in water for several hours to achieve full size of 7-8 mm (1,2,4). The water beads and other similar products, such as gel beads, water orbs, and gel balls, are available in multiple colors and finishes, including "shimmer" and glow in the dark (1). Their small size and bright colors give these water beads the appearance of candy, and they are easily ingested. If ingested as seeds, the beads will expand in the gastrointestinal tract, where they have been found to grow well beyond their purported full size of 8 mm to as much as 40 mm, causing bowel obstruction (3).
Detecting water beads on imaging is a challenge for the pediatric radiologist, but localization of the beads before intervention can aid the surgeon or gastroenterologist in their retrieval attempts. Radiographs are poor detectors of their thin membranes and majority fluid composition. If there is a high index of suspicion for ingestion, CT is often second-line for detection of the fluid-filled orbs and evaluation of intestinal obstruction. However, in the pediatric population, in whom keeping radiation exposure to the lowest reasonably achievable levels is paramount, ultrasound (US) is a valuable tool for diagnosis of bowel obstruction. US demonstrates equal sensitivity and increased specificity in comparison to radiography. In addition, US is an excellent tool for identifying the beads themselves, which appear as well-circumscribed, rounded, anechoic structures within the bowel lumen. Importantly, US is readily available, is easy to use, and obviates exposure to radiation in young children.
We present a case of ingested water beads diagnosed by US to demonstrate the utility of US in identifying both the beads and potential bowel obstruction in young children.
References:
1. https://www.spinmaster.com/en-US/brands/orbeez/
2. https://www.healthychildren.org/English/safety-prevention/at-home/Pages/Water-Beads-Harmful.aspx
3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7808832/
4. https://www.amazon.com/Blaster-Splatter-Electric-Automatic-Manual/dp/B09YBYR2T7
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