Accidental Foreign Body Ingestion Resulting in Detection of an Asymptomatic Colorectal Carcinoma

Abstract

Foreign body ingestion is a fairly common clinical problem. The clinical course and resultant management is typically uncomplicated and will usually be predicted from the characteristics of the foreign body itself. However, an abnormal gastrointestinal tract segment can result in a complicated outcome. This article demonstrates such an example when an ingested foreign body that should have passed uneventfully, instead caused colonic obstruction by obturating a previously asymptomatic colon carcinoma. A 70 year old gentleman presented to the emergency department with onset of abdominal pain a few days following accidental ingestion of his dental crown. An initial plain abdominal radiograph followed immediately by a contrast enhanced abdominal MDCT showed an intraluminal metallic density foreign body, compatible with the ingested crown, causing obstruction at the splenic flexure lodging at a 3cm focal “apple core” lesion. Rapid decompression via colonic stent was then facilitated. Acute colonic obstruction due to accidental ingestion of a foreign body is rare. Plain film radiography may suffice for imaging of the uncomplicated foreign body ingestion. However, CT scanning, with the added technical development of 3D reconstruction capability can provide critical information in certain circumstances.