Colitis cystica profunda: colonoscopic and pathological findings

Abstract

ured 16 cm in length (Figure 1c), the patient made an uneventful recovery. Further questioning elicited his admission that the pen had been inserted anally, not swallowed. COMMENT In view of the difficulty encountered in guiding this long objectthrough the sigmoid colon, we cannot account for its spontaneous retrograde passage. The clinical picture negates the possibility that, on insertion, it perforated the rectum and then re-entered the descending colon. It should be self-eVident that a radiopaque foreign body may be contained within a larger, more rigid, radiolucent object. This has obvious implications regarding expected size, flexibility, and ease of removal. . Finally, to the credit of the manufacturer, it should be noted that the pen, the brand name of which had been obliterated, was found to be fully functional after extraction and was used to write the pathology requistion (after washing) when the endoscopist could not find his own. Robert M. Richter, MD* leon littman, MD Surgical Endoscopy Service Jewish Hospital and Medical Center Brooklyn, New York It is fortunate that among the wide variety of foreign bodies inserted into the rectum, few mig~ate proximally into the bowel above the distal sigmoid colon. Especially long objects, particularly rigid ones, are hindered in retrograde passage by the flexures of the sigmoid. Without burdening the reader with a recitation of references to those which have made this circuitous journey prior to endoscopic extraction, we wish simply to present an oddity. CASE REPORT A 15 year old boy was admitted because of abdominal cramps, vomiting, and diarrhea since accidental ingestion of a ball-point pen refill several days earlier. Examination showed no positive findings except for moderate, generalized, abdominal tenderness without rebound. The white blood cell count was normal. Endoscopic extraction of an unusual colonic foreign body