Treatment Of Foreign Bodies Research Articles

Removing a pin from the urethra of a 14-year-old male patient: a case report

The diagnosis and treatment of foreign bodies in the urogenital system are difficult and it’s rare in children; It may also cause secondary injuries. In this article, we present a 14-year-old male patient who was admitted to the emergency outpatient clinic with complaints of difficulty in voiding and dysuria. He was diagnosed with a pin in the urethra and treated using an endoscopic method. He was hospitalised for foreign body removal after he admitted in his anamnesis about insertion a pin into his urethra the day before his complaints started. A pin was seen in the urethra on the urethrocystoscopy, and was successfully removed. Since foreign body in the urogenital system is rare in children, it is necessary to suspect, in order to make the diagnosis. In most cases, endoscopic intervention is sufficient. Psychiatric consultation should be requested for the patients, especially for pediatrics.

Foreign bodies in children's lower urinary tract: A case series and literature review.

Children with foreign bodies (FBs) in the lower urinary tract have rarely been reported, and their management remains challenging. This study aimed to describe the characteristics and treatment of FBs in children's lower urinary tract. We retrospectively analyzed the clinical data on lower urinary tract FBs that were removed in our hospital from August 2017 to August 2022, including demographics, location, symptoms, imaging examinations, and treatment. Four male patients were enrolled, whose ages ranged from 9 to 13 years, with a mean age of 11 years. The course of the disease ranged from 3 h to 2 weeks. Their imaging characteristics were reviewed and analyzed, and two FBs were located in the bladder and two in the urethra. Mosquito forceps were used to remove an acne needle through the urethra in one case. Cystoscopy was first attempted in three cases, in only one of which was the FB removed successfully under endoscopic minimally invasive surgery. In the remaining two cases, removal via transurethral cystoscopy failed, whereby leading to cystotomy being performed. The FBs comprise a skipping rope, hairpin, magnetic bead, and acne needle. The postoperative recovery was uneventful, and no complications occurred during the follow-up period of 3 to 6 months. It is rare for children to have FBs in the lower urinary tract. An early diagnosis, as well as appropriate management of lower urinary tract FBs, can significantly reduce complications. Surgical removal of lower urinary tract FBs can be safe and effective, and relatively better outcomes can be achieved.

S588 Cap Assisted Endoscopic Treatment of Esophageal Food Bolus and/or Foreign Body Ingestion: A Systematic Review and Meta-Analysis

Introduction: Esophageal food bolus and/ or foreign body (FB) impaction is one of the most common gastrointestinal emergencies where early endoscopic intervention is warranted. Early time to intervention with faster procedure time are associated with good patient outcomes. In recent literature, cap assisted endoscopic removal of esophageal FB seems to be associated with favorable outcomes as compared to conventional methods. This meta-analysis reports on the pooled outcomes of cap-assisted endoscopic removal of esophageal FB. Methods: We conducted a comprehensive search of several databases including Medline, Scopus, Embase, from inception to February 2022, to identify studies reporting on the use of cap in endoscopic treatment of esophageal FB. Standard meta-analysis methods and random effects model was used to calculate the pooled odds-ratio (OR) and mean-difference (MD) with corresponding 95% confidence intervals (CI). I2% statistics was used to assess the heterogeneity. Results: Six studies were included that evaluated 677 patients treated with cap-assistance and 694 patients treated with conventional methods. Peptic stricture (32%) and eosinophilic esophagitis (20%) were the most common esophageal disorders. Cap-assisted method demonstrated statistically significant pooled OR for technical success: 7.1 (95% CI [1.9-26.9, p=0.004, I 2%=0]), and enbloc removal: 26.6 [17.6-40.2, p< 0.001, I2%=0], with significantly faster procedure time, MD: -4.6min [-6.5to-2.8, p< 0.001, I2%=99]; when compared to conventional method. Better technical success was achieved with cap-assisted method done under general-anesthesia (OR: 8.7, 1.6-47.7, p=0.01, I 2%=0), but faster procedure time was noted with cap-assisted method performed without general-anesthesia (MD: -1.5, -2.7to-0.4, p=0.01, I2%=99). Pooled adverse events were comparable. However, pooled OR of mucosal tear was significantly less with the use of cap in food-bolus impactions (OR: 0.07, 0.01-0.38, p=0.02, I2%=0). No airway related adverse events were reported when general anesthesia was not used. (Figure) Conclusion: This meta-analysis demonstrates significantly better pooled technical success, enbloc removal and faster procedure time with cap-assisted endoscopic removal of esophageal food-bolus and/ or foreign-body impaction as compared to conventional method. With cap-assistance, faster procedure time seems achievable without the need for general anesthesia. However, additional randomized controlled trials are required to further validate this finding.Figure 1.: Summary of pooled results

Extraction of foreign bodies from the upper gastrointestinal tract (а literature review)

Introduction. Swallowing foreign bodies is a common case in children which can cause a large number of complications. The statistics informs that 80% of cases are met in children aged from 6 months to 6 years. Late detection of foreign bodies is associated with a high risk of life-threatening complications. Timely detection and removal of foreign bodies is a relevant problem in modern medicine. Material and methods. A literature review was made by keywords on the diagnostics and treatment of foreign bodies in the gastrointestinal tract in databases Scholar, Pubmed, Medline, Google.Results. On analyzing the obtained literature data, the authors describe in details types of the approach to diagnose and remove foreign bodies in the gastrointestinal tract. Two large options were identified: non-endoscopic and endoscopic. Besides, the authors make a review of other unique techniques for removing foreign bodies proposed by various authors.Conclusions. The obtained and analyzed literature data demonstrate that even the authors who offer different curative options recognize that endoscopy is the most safe and effective one for removing various objects. However, despite the obvious advantages of endoscopy in removing foreign bodies, it should be borne in mind that this technique is possible to apply only under certain conditions: namely, proper equipments and hospital setting, as well as experienced and trained personnel.

The Heart and Vessels Foreign Bodies. A 3-Year Review

Introduction Foreign bodies in the heart and vessels are rare. They are usually iatrogenic. They get to the heart through different ways. They may cause serous complication including embolism and arrhythmias. They can could be diagnosed with X-ray, computerized tomography, and echocardiography. They are removed by endovascular percutaneous, surgical or conservative. In this four-year review, we analyzed identify and analyzed the treatment of foreign body referred to the Bayelsa Specialist Hospital. Methods We searched the cardiac catherization records of the hospitals and identify 11 foreign bodies referred for the period of 1st January 2018 and 30st April 2021. The site, etiology, clinical presentation, symptoms, complications and management modality, and outcome were noted. Results The patients mean age was 57. There were more women than men 8 versus 4 [P &lt; 0.002]. The most common foreign bodies were parts of inferior vena cava filters and devices. Foreign bodies in the heart were symptomatic in 76% of patients. Right atrial chamber, inferior and superior vena-cava were occupied more often. A total of 78% presented within the first 24 hours. A majority of foreign bodies reached the heart by migration. There was no mortality among those treated with endovascular percutaneous therapy. All those treated in our center were by endovascular percutaneous and conservative therapy. Conclusion Foreign bodies in the heart and vessels may be asymptomatic or present with a wide variety of symptoms. Health care providers should be aware of this rare event and act fast dealing with it.

ASSESSMENT OF LOCAL MUCOCILIARY CLEARANCE OF THE MIDDLE NASAL MEATUS AFTER DIFFERENT TYPES OF SURGICAL ACCESS TO THE MAXILLARY SINUS

Abstract. The paper considers an original method for asessment the ciliar beating frequency (CBF) of the ciliated epithelium (mucociliary clearance) of the nasal mucosa using modern high-speed digital video recording of the microscopic picture of the brushed specimen, which followed by mathematical processing. This method used to study the local mucociliary clearance of the middle nasal meatus, which plays a key role in the modern understanding of the osteomeatal complex function. The normal values of the CBF of the middle nasal meatus in healthy individuals (11.76 ± 3.01 Hz) were determined. We studied the changes in the CBF of the ciliary epithelium of the middle nasal meatus with foreign bodies of the maxillary sinus. A correlation found between changes in the CBF of the ciliary epithelium of the middle nasal meatus and the CT changes in the region of the middle nasal meatus and paranasal sinuses. This also determined the effect of surgical trauma on the CBF of the middle nasal meatus and its changes in the early (up to 1 month) and late (1-6 months) following period. We clearly proved the dependence of the mucociliary clearance of the middle nasal meatus on the type of surgical access to the maxillary sinus during surgical interventions for foreign bodies of the maxillary sinus. We revealed certain advantages of transmaxillary and prelacrimal surgical access to the maxillary sinus over endonasal antrostomy during surgical interventions for foreign bodies of the maxillary sinus. Our data allow optimizing surgical interventions on the maxillary sinus with minimization of surgical trauma to the ciliary epithelium of the middle nasal passage and improving the functional and morphological results of surgical treatment of foreign bodies in the maxillary sinuses.

Small spherical foreign bodies in the genitourinary tract and their management

BackgroundUrogenital small foreign bodies (FBs) have rarely been reported in children, and their management is still challenging. This study aimed to describe the characteristics and treatment of spherical FBs no larger than 0.6 cm in the children’s genitourinary tracts. Methods The clinical data of spherical FBs removed in our hospital from June 2013 to June 2020 were recorded and retrospectively analyzed, including demographics, location, symptoms, imaging examinations and treatment methods. Results A total of 10 patients were enrolled: 6 girls and 4 boys. Their ages ranged from 5.1 to 16.8 years old, with a mean age of 9.2 years. The course of the disease ranged from 3 h to 1 year, and symptoms recurred in some cases. Their imaging characteristics were reviewed and analyzed, 6 patients underwent color Doppler ultrasonography, 1 patient was suspected to have an FB in the vagina, 7 patients underwent an X-ray examination, and FBs were revealed in 6 patients. All FBs were removed under endoscopic minimally invasive surgery. Six vaginal FBs were successfully retrieved via vaginoscopy, and in the other four cases, removal by transurethral cystoscopy failed because of mutual attraction, which was eliminated by laparoscopy under pneumovesicum. Postoperative recovery was uneventful; in a follow-up of 3 months to 2 years, there was no perforation or fistula formation, and there were no urethral strictures in boys. Conclusion Small spherical FBs are clinically rare; they are sometimes difficult to detect by imaging examinations and can be easily overlooked. Minimally invasive endoscopy remains the first-line approach for the diagnosis and removal of genitourinary spherical FBs.

Needle as foreign body in urethra: Successful removal

: Self-inserted foreign bodies in the lower urinary tract are rare among children. The treatment of foreign bodies in the urethra is determined by their type, size, location, shape, and mobility. : We describe here a 10-year-old boy who had self inserted a needle into his urethra. Initial attempts to remove the needle from the urethra by inserting a cystoscope failed. The patient presented to our institution with bleeding per urethra with feeding tube insitu per urethra. As already attempted for urethroscopic removal, direct removal of needle done under general aneathesia done.: Per Rectal examination plays an important role and gives adequate information and timely management of the child leads to uneventful hospital stay Psychiatric evaluation is mandatory to detect an underlying mental disorder.

Endoscopic Image-guided treatment of Upper Gastrointestinal foreign body and nursing care of complications.

Objective:This study used phased array imaging algorithm to explore the epidemiological characteristics of endoscopic treatment of upper gastrointestinal foreign bodies to provide a basis for nursing intervention.Methods:We collected data on the age, sex, cause, type of foreign body, success rate of removal, retention location, time and complications of patients with foreign bodies in the upper gastrointestinal tract who were treated in the emergency department of the Digestive Endoscopy Center in our hospital. The study was conducted from January 2018 to December 2020 and we also performed statistical analysis.Results:The high incidence of foreign bodies in the upper digestive tract was in 45 years old to 74 years old patients. The foreign body types were mostly food balls and sharp foreign bodies, accounting for 37.0% and 44.2%, respectively. The cause was misuse and the most accounted for 52.1%, followed by oesophageal pathological stenosis which accounted for 45.5%. The oesophagus in the retention site accounted for up to 80.0%, and the success rate of foreign body extraction was 96.4%. The complications of patients with foreign body retention within twenty four our retention were mainly esophageal scratches and traumatic esophagitis, accounting for 48.5%. 39.6%.Conclusion:There are high risks in the treatment of foreign bodies in the upper digestive tract. Targeted, prospective, and streamlined nursing interventions can provide patients with fast and professional medical care services and minimize patient pain.

Foreign bodies in the ear, nose, and throat of children - A 10 years' experiences at a tertiary care teaching hospital

Background: Foreign bodies (FBs) in the ear, nose, and throat are frequently encountered clinical entities among the children. These ear, nose, and throat FBs are often seen by pediatricians, primary care physicians, and otolaryngologists. Aim of the Study: The objective of this study is to analyze various types of FBs in the ear, nose, and throat among children and its clinical profile with its treatment in the pediatric age group. Materials and Methods: This descriptive retrospective study was carried out at a tertiary care teaching hospital. During 10-year period from April 2010 to May 2020, 452 pediatric patients with FB in the ear, nose, and throat were managed. The clinical profile and management of these children were analyzed. The clinical data were collected from the admission charts and clinic tickets. Results: In this study, the majority of the FBs were found in the nasal cavity, which constitutes 30.53%, whereas 28.31% found in the external auditory canal, 11.72% in the pharynx, 13.49% in the esophagus and 15.72% in laryngotracheobronchial (LTB) tract. The age ranges from 0 to 16 years, with a mean age was 7.21 years. The majority of the ear, nose, and throat FBs were found in the age group of 0–5 years. Out of the 452 cases, 243 (53.76%) were removed under general anesthesia. Vegetable seed was the most common FB in the nose. Coin was the most common FB in the esophagus, whereas vegetable seeds were the most common FB found in the bronchus. The open safety pin is a hazardous LTB FB. Conclusion: FBs in the ear, nose, and throat of children are common. The accurate diagnosis and treatment of the FBs in the pediatric age is often challenging. These FBs can be associated with significant morbidity and complications if not removed immediately.

Aortic penetration due to a fish bone: a case report

BackgroundAortoesophageal fistula (AEF) caused by an esophageal foreign body is a life-threatening crisis, with rapid progress and high mortality. The first case of AEF was reported in 1818, but the first successfully managed case was not until 1980. Although there have been some reports on this condition, in most cases, the aorta was invaded and corroded due to its adjacent relationship with the esophagus and subsequent mediastinitis. To date, few reports have described an aortic wall directly penetrated by a sharp foreign body, likely because this type of injury is extremely rare and most patients cannot receive timely treatment. Here, we present a rare case of a fish bone that directly pierced the aorta via the esophagus.Case presentationA 31-year-old female experienced poststernum swallowing pain after eating a meal of fish. Gastroscope showed a fishbone-like foreign body had penetrated the esophagus wall. Computed tomography revealed that the foreign body had directly pierced the aorta to form an AEF. Surgery was successfully performed to repair the aorta and esophagus. The postoperation and follow-up was uneventful.ConclusionsFor the treatment of foreign bodies in the esophagus, we should be alert of the possibility of AEFs. The effective management of AEFs requires early diagnosis and intervention, as well as long-term treatment and follow-up, which still has a long way to go.

An Unusual Self-Inflicted Foreign Body in the Urinary Bladder and Urethra: A Case Report

Introduction: Most foreign bodies in the lower genitourinary tract are self-inserted via the urethra as the result of exotic impulses, psychometric problems, sexual curiosity, or sexual practice while intoxicated. Diagnosis of these foreign bodies can be done by clinical history, physical examination, and image studies of the patient. The treatment of foreign bodies is determined by their size, location, shape, and mobility. In most cases, minimally invasive procedures such as endoscopic removal are recommended to prevent bladder and urethral injuries. In some cases, however, surgical treatment should be done if the foreign bodies cannot be removed by the endoscopic procedure or further injuries are expected as a result of the endoscopic procedures. Case Presentation: Herein we present a case of self-inserted lower genitourinary foreign body. A 60 years old man presented with complaints of dysuria, dribbling, haematuria and suprapubic pain for 3 weeks. An X-ray of the pelvis showed a coiled up radio opaque shadow of telephone wire in the bladder region extending downwards which was removed by suprapubic cystostomy. Discussions: Bladder foreign body is not common. Plain radiograph is sufficient to diagnose and minimally invasive procedure is usually successful. In this case retrieval by cystostomy was done to avoid the risk of bladder and urethral injury. Conclusion: Introduction into the bladder may be through self-insertion, iatrogenic means or migration from adjacent organs. Extraction should be tailored according to the nature of the foreign body and should minimize bladder and urethral trauma. The possibility of an intravesical foreign body should be considered in any patient with chronic unexplained lower urinary tract symptoms. Bangladesh Journal of Urology, Vol. 18, No. 2, July 2015 p.94-97

Clinical diagnosis and treatment of throat foreign bodies under video laryngoscopy.

ObjectiveThis study was designed to explore the clinical application of video laryngoscopy in the diagnosis and treatment of throat foreign bodies (FBs).MethodIn total, 1572 patients diagnosed with throat FBs at the Department of Otolaryngology of Nanjing Drum Tower Hospital were retrospectively analysed. The covariables collected were the time from FB ingestion to admission, age, sex, duration of admission, and site of impaction.ResultThe most common FBs were fish bones, which accounted for 1446 (91.98%) of 1572 FBs. Among all 1572 FBs, 1004 (63.87%) were successfully removed by video laryngoscopy without complications. A shorter duration of admission was associated with a higher diagnostic rate under video laryngoscopy. The diagnostic rate of sharp FBs was significantly higher than that of non-sharp FBs. The most common sites of throat FBs were the tongue root (42.29%), epiglottic vallecula (19.40%), tonsil (18.21%), and piriform fossa (10.65%).ConclusionVideo laryngoscopy is a powerful tool for the diagnosis and treatment of throat FBs, allowing for identification of rare locations of FBs as well as refractory FBs.

Symposium 4 “Airway and Esophageal Foreign Body Treatment Techniques to Convey to Future Generations” —Introduction

Symposium 4 “Airway and Esophageal Foreign Body Treatment Techniques to Convey to Future Generations” —Introduction

Urethrovesical Foreign Body in Adolescents: Two Case Reports

Urethrovesical foreign body, though uncommon, can be seen in children and adolescents. The self-insertion of different objects via urethral meatus is usually for sexual stimulation. Treatment of foreign bodies in the urinary tract can be a challenging problem for pediatric surgeons and urologists and it is usually a urologic emergency. The pediatric patient usually adolescents may complain of lower urinary tract symptoms and recurrent urinary tract infection. Late presentation and hesitancy to report to a doctor are possible due to a feeling of embarrassment. Urethrocystocopy is considered ideal for the removal of foreign objects but in some cases and open surgery is required. The authors present two cases. One is a 15-yearold male who inserted a flex electrical wire into his own urethra and subsequently into the bladder for self-erotic stimulation. The second case is a 16-year-old male with an over 6-month history of recurrent urinary infection post insertion into the bladder the coated electrical wire.

Approach to foreign bodies in the upper Gastrointestinal system

Objective: The aim of this study is to reveal the clinical presentations and treatment approaches to the patients applied with foreign body ingestion and food residue accompanied by literature. Materials and Methods: Patients who were admitted to the general surgery clinic of Ceylanpinar State Hospital between March 2018 and March 2019 with the suspicion of ingestion of foreign bodies in the upper gastrointestinal tract and food residue were evaluated retrospectively. Findings: The mean age of our patients was 31.3 (min-max: 18-76). Endoscopy without sedation was performed to 3 patients (37.5%) due to the feeling of stuck. In 2 patients, the bone fragments detected in the esophagus were excised with the help of endoscopic forceps. One of the three endoscopic procedures have failed. Patient whose endoscopy was unsuccessful and five other patients were followed-up medically in order to let foreign bodies or food residues to leave the digestive tract spontaneously. None of the patients had esophageal disease or a known psychiatric disorder. The mean duration of admission to the hospital was 12.5 (min-max: 6-36) hours. Three patients (37.5%) had foreign body feeling and dysphagia. Four of the patients (50%) had foreign bodies and the rest of the patients had food residue. The localization of foreign bodies or food residues were detected as; stomach in 1 patient (12.5%), esophagus in 3 patients (37.5%) and intestines in other 4 patients (50%). None of the patients required surgical intervention. Conclusion: In the early period, endoscopic procedures show a high success rate without complications in the treatment of foreign bodies in the upper gastrointestinal tract. However, it is an appropriate approach to wait for the spontaneous exit of the foreign body in cases that the foreign body have already passed the upper gastrointestinal system.

Endoscopy treatment on gastrointestinal tract foreign body in children

As a common disease in pediatric outpatient and emergency departments, foreign bodies in digestive tract of children can occur in all ages.Foreign bodies in digestive tract is swallowed accidently or deliberately, which can neither be digested nor be absorbed in gastrointestinal tract.Early and timely diagnosis of foreign bodies in digestive tract which failed to pass spontaneously through the gastrointestinal tract or caused gastrointestinal tissue damage should be fully assessed and perfect auxiliary examination.Emergency endoscopic treatment with high success rate, less complications and quick recovery of organ function has become the best treatment for foreign bodies in digestive tract and is worth for extensive application in the clinic. Key words: Children; Foreign body; Endoscopy

Aural and nasal foreign bodies in children – Epidemiology and correlation with hyperkinetic disorders, developmental disorders and congenital malformations

ObjectivesForeign body incorporation in children is often a serious situation. Attention deficit hyperactivity disorder (ADHD) could be a risk factor for self-insertion of foreign bodies. Large cohort analyses are missing. MethodsThis was a retrospective analysis of patients’ records from a health insurance company representing 2.19% of the German population and 1.75% of German children and adolescents. According to the International Classification of Diseases, children in the age range between 1 and 18 years have been screened for foreign bodies in ear, nasal sinus and nostrils as well as for hyperkinetic disorders (F90), disorders of psychological development (F80–F89), and congenital malformations, deformations and chromosomal abnormalities (Q00–Q99). ResultsIn total, 12887 children (6609 male; 6278 female) have been treated in 16929 cases. The majority (n = 10041 (77.9%)) presented with foreign body incorporation on a single occasion. On average, 1.31 cases of foreign body treatment were recorded per child; 14.1% of children with foreign body treatment (FBT) also had a record of hyperkinetic disorder, 52.7% had a disorder of psychological development, and 50.8% a congenital malformation. Mean occurrence of FBT was 174.8 days before the diagnosis of a hyperkinetic disorder but 517.2 days after the diagnosis of a psychological development disorder and 683.1 days after the diagnosis of a congenital malformation, deformation or chromosomal abnormality. ConclusionPatients with disorders of psychological development as well as children with congenital malformations are high-risk patients for nasal and aural foreign bodies. The prevalence of a hyperkinetic disorder in patients with FBT is much higher than in the normal population. ADHD is a risk factor for foreign bodies.

Esophageal foreign bodies in adults: systematic review of the literature

Objective: Esophageal Foreign Body (FB) impaction represents a major challenge for healthcare providers. Aim of this systematic review was to analyse the current literature evidence on prevalence, presentation, treatment, and outcomes of impacted esophageal FB. Materials and methods: Literature search was conducted between 2000 and 30th June 2018 according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. Results: Sixty-one studies matched the inclusion criteria. The total number of included patients was 13,092. The cervical esophagus was the most frequent impaction site (67%) and sharp-pointed objects were the most common FB (38.1%). Retrosternal pain (78%), dysphagia (48%), and odynophagia (43.4%) were the most common symptoms. A flexible or rigid endoscopic approach was adopted in 65.1% and 16.8% of patients, respectively. Overall, 17.8% of patients had a complication related to the impacted esophageal FB or to the endoscopic manoeuvers. A surgical approach was required in 3.4% of patients. The overall mortality was 0.85%.Conclusions: Surgery is the upfront treatment in patients with esophageal perforation or endoscopically irretrievable esophageal FB. A minimally invasive approach can be adopted in selected patients. Effective prevention of FB impaction should focus on accurate diagnostic work-up to search for an underlying motility disorder after a first episode of esophageal impaction, even if transient and self-resolving.

A Case of the Missing Ring

Introduction: The ingestion of foreign bodies is most frequently observed in children and in adults with underlying psychiatric disease. Foreign bodies generally cause little morbidity if properly managed. Roughly 90% of foreign bodies pass through the gastrointestinal tract with 10-20% requiring endoscopic removal and up to 1% requiring surgical intervention. The diagnosis is usually apparent from a patient's clinical history; however, radiographs of the neck, chest and abdomen may be required in the case of patients that are poor historians. Case: The patient is a 51 year old asymptomatic man status post appendectomy in 2000 who presented for outpatient index average risk colorectal cancer screening in June 2017. He subsequently underwent a colonoscopy during which a stricture was found to be causing moderate obstruction in the ascending colon that was not traversable with an adult colonoscope. There was evidence of mucosal scarring at the site. Several cold forcep biopsies were taken, revealing colonic mucosa with rare focal active colitis and prominent lymphoid aggregates. A CT scan of the abdomen/pelvis with IV contrast was performed which revealed moderate stool burden and an indeterminate 2.5 cm metallic ring in the lumen of the terminal ileum at the ileocecal valve with associated small amounts of mural edema and inflammation involving the ileocecal valve and adjacent terminal ileum. The patient was subsequently admitted and colorectal surgery was consulted. Given the risk for erosion and obstruction, the patient was taken to the operating room for surgical resection. An ileocecectomy was performed, in which 12.5 cm of a single segment of bowel was resected and a side to side ileo-colonic anastomosis was created. Discussion: The treatment of foreign bodies is largely dependent on the foreign body ingested, location, and time since ingestion. The vast majority of foreign bodies will pass on their own; however, some do require endoscopic or surgical intervention given the risk of obstruction or erosion with subsequent perforation. The case as described above is a classic example of foreign body ingestion in which surgical intervention was indicated.1618_A Figure 1. Stricture- Stellate scar1618_B Figure 2. CT abdomen- ring at ileocecal junction