A Surgical Extraction of Seven Charging Cables
A 22-year-old man with autism spectrum disorder (ASD) required an open supraumbilical laparotomy to remove a massive gastric bezoar composed of intertwined mobile phone charging cables. The case, detailed in Cureus, highlights a rare medical emergency where the patient presented with recurrent absence seizures, initially masking the true nature of his condition.
Radiographic Evidence of a Hidden Obstruction
The discovery occurred during an emergency evaluation for the patient’s seizures. A plain abdominal radiograph revealed a dense network of linear, serpiginous radiopaque structures shaped to the contour of the stomach. Despite the mass, the patient displayed no classic symptoms of bowel perforation, such as abdominal pain or vomiting. Clinicians identified a history of pica—a condition involving the persistent ingestion of nonnutritive substances—noting the patient had undergone a previous laparotomy seven years ago for the ingestion of batteries and magnets.
The Limitations of Endoscopic Retrieval
Surgeons attempted a metallic snare extraction, but the cables remained fixed and immobile. Attempting further traction posed a high risk of mucosal injury or perforation, forcing the team to pivot to surgery.
Psychiatric Teams Monitor Patient Recovery
The patient’s postoperative course was uncomplicated. To mitigate the high risk of recurrence, psychiatric services have established a formal outpatient follow-up plan.
The Mechanics of Cable Entanglement
Charging cables present a unique challenge compared to softer bezoars like hair or food fiber. Their length, flexibility, and metallic connectors cause them to entangle and become mechanically fixed within the gastric lumen. This structural complexity often renders standard endoscopic snares ineffective, as the mass cannot be safely grasped or mobilized. Left untreated, such foreign bodies can cause erosive mucosal injury, pressure-related ulcerations, and, in severe instances, gastric outlet obstruction or perforation.
Clinical Context of Pica in ASD
The Cureus report emphasizes that pica occurs with significantly higher prevalence in individuals with ASD than in the general population. For clinicians, the presence of neurodevelopmental disorders serves as a primary indicator to investigate potential foreign-body ingestion, even when patients present with atypical symptoms. This case follows a long-standing medical understanding that when endoscopic removal fails, direct access via open or laparoscopic gastrotomy remains the standard for ensuring the mass is removed en bloc without leaving sharp, dangerous debris behind.
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