[An ileo-caecal foreign body mimicking a Crohn disease: case report]

Foreign-body ingestion is a common cause of admission to the Division of Gastroenterology. However foreign-body lodged in the ileocecal region is very rare. This study aims to report the exceptional case of a patient with a foreign body lodged in the ileocecal region revealed by sub-occlusive syndromes. The study involved a patient aged 22 years with no particular past medical history, presenting with König's syndrome evolving in a context of alteration of the general state. Anatomopathological examination of surgical ileocecal specimen performed after inconclusive endoscopy, histologic examination of the biopsies and scannography, showed ileocecal thickening due to infammatory response to a foreign body. In the absence of anamnestic data, ileocecal foreign body poses a real problem of differential diagnosis including inflammatory, infectious and tumoral diseases of the ileocecal junction. The presence of a foreign body may be revealed by occlusive complications or perforations, hence the essential role of imaging. Endoscopy always plays a central diagnostic and therapeutic role in the management of ingested foreign bodies, thus reducing surgical morbidity (although it is sometimes unavoidable). Anatomopathological study shows foreign body granuloma. Cases of foreign body lodged in the ileocecal region have been rarely reported. Now they should be suspected in patients with any symptom, including ileocecal junction disorders, in order to avoid side effects and complications due to heavy treatments.