Unusual Cause of Distress in an Intellectually Disabled Adolescent: A Reminder to Suspect Foreign Body Ingestion

Foreign body ingestion is a common yet often underdiagnosed condition in intellectually disabled, nonverbal patients due to atypical presentations. Early recognition is essential to prevent serious complications. A 17-year-old nonverbal boy with intellectual disability presented with abnormal posturing and agitation, initially suspected to be a seizure episode. Radiological imaging revealed a large, round, radiopaque object in the esophagus, later identified as a whole lemon. The object was successfully displaced distally during endoscopic intervention. In patients with limited communication abilities, foreign body ingestion can mimic neurological or behavioral disorders. Maintaining a high index of suspicion, along with prompt radiological evaluation and timely endoscopic intervention, is critical to prevent airway compromise and other complications. Clinicians should consider foreign body ingestion in intellectually disabled or nonverbal patients presenting with unexplained neurobehavioral symptoms. Early diagnosis and intervention are crucial for favorable outcomes.