Sunflower Seed Ingestion

Several hours before he was seen in the office, a 2-year-old boy passed stool that contained a large intact sunflower seed. He had poor appetite and abdominal cramps but no recent history of emesis or fever.

Vital signs were within normal limits. The child's abdomen was tender and slightly distended; bowel sounds were hyperactive. Digital rectal examination revealed multiple sunflower seeds, most of which were manually evacuated. The remaining seeds in the upper rectum and lower sigmoid colon were removed with a flexible sigmoidoscope. Mucosal irritation was noted, but endoscopic findings were otherwise normal. A large handful of seeds was removed. The child fully recovered.

A 4-year-old playmate had given the seeds to the boy while the children had been playing without parental supervision. The parents were educated about the potential dangers of sunflower seed ingestion for both the 2-year-old and the 4-year-old (including airway obstruction from seed aspiration, and bowel obstruction and perforation). The lack of responsible adult supervision was of particular concern. The Department of Social Services was involved in this case; however, the boy's mother was not found negligent. *