Spontaneous Passage of an Accidentally Ingested Metallic Bullet Casing in an Adolescent: A Case Report

Background Accidental ingestion of foreign objects is common and can lead to severe complications. While frequently encountered in children and certain high-risk adult populations, such occurrences remain rare in healthy adolescents without predisposing factors. Case Presentation: We report the case of a 17-year-old female who inadvertently swallowed a metallic bullet Casing during a meal. She presented two hours post-ingestion without any alarming symptoms aside from a mild sore throat. Serial abdominal X-rays confirmed the bullet’s progression through the gastrointestinal tract without evidence of perforation or obstruction. After close inpatient monitoring, including regular clinical evaluations and sequential imaging, the bullet was spontaneously passed per rectum. The patient remained asymptomatic, and subsequent follow-ups revealed no complications. Discussion Most ingested foreign bodies pass spontaneously, especially if they are small, blunt, and free of sharp edges. This case underscores the importance of careful patient selection for conservative management. Regular monitoring with clinical assessments and radiographic imaging can safely guide management decisions in asymptomatic patients without psychiatric, neurodevelopmental, or underlying gastrointestinal conditions. Conclusion In healthy adolescents who accidentally swallow a foreign body, conservative management with vigilant monitoring can be both safe and effective. This approach minimizes unnecessary invasive interventions, provided that there are no signs of obstruction, perforation, or ongoing complications.