Abstract
Granulomas are a well recognised entity in gastrointestinal surgery. These are mainly foreign body granulomas (formed in response to a foreign irritant, such as a suture material from a prior surgery, talc, contrast material) and immune granulomas (in chronic inflammation). On histopathology, the foreign body giant cell reaction contains multinucleate giant cells with nuclei that are distributed through the eosinophilic cytoplasm, in which the culprit foreign material may often be evident. Here we present an interesting case of a distal ileal obstruction and perforation due to a foreign body granuloma in a male with no prior history of surgery or even endoscopy where no definitive inciting foreign body could be isolated on histopathology, leaving the cause of his foreign body reaction to remain a mystery.
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