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

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

Bullet casing, Foreign body ingestion, Adolescent, Conservative management, Gastrointestinal tract,
Emergency department

Abstract
Background 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.
Case presentation 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.
Discussion 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.
Conclusion 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.
Keywords Bullet casing, Foreign body ingestion, Adolescent, Conservative management, Gastrointestinal tract,
Emergency department

Sowdo Nur Iyow1

, Abdullahi Ahmed Ahmed1* , Abdulkadir Nur Mohamed2

, Shuayb Moallim Ali Jama3
and

Hassan Adan Ali Adan1

https://doi.org/10.1186/s12245-025-01047-3

2025

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