Endoscopic foreign body retrieval from the caecum - A case report and push for intervention guidelines

Area of Science:

• Gastroenterology
• Minimally Invasive Surgery
• Gastrointestinal Endoscopy

Background:

• Endoscopic foreign body retrieval in the upper GI tract is established.
• Indications for lower GI tract foreign body retrieval, particularly in the right colon, are less defined.
• Foreign body ingestion (FBI) can necessitate surgical intervention, especially in recurrent cases.

Purpose of the Study:

• To supplement existing literature on endoscopic retrieval of right-sided colonic foreign bodies.
• To contribute to the eventual establishment of guidelines for colonoscopic retrieval of right-sided foreign bodies.
• To document indications for endoscopy in recurrent FBI with a history of multiple laparotomies.

Main Methods:

• A 36-year-old male with a history of intentional foreign body ingestion underwent CT and X-rays.
• The foreign body (6.5 cm nail clippers) failed to pass the cecum over two weeks.
• Successful endoscopic retrieval was achieved via colonoscopy.

Main Results:

• Colonoscopy successfully retrieved a 6.5 cm nail clipper lodged in the right colon.
• The patient recovered without further complication after a temporary episode of laryngospasm.
• This case demonstrates the feasibility of colonoscopic retrieval in complex FBI cases.

Conclusions:

• Colonoscopy should be considered for right-sided colonic foreign bodies that fail to pass spontaneously.
• Endoscopic retrieval offers a less invasive alternative to surgery in patients with multiple comorbidities or prior laparotomies.
• This case report details specific indications for endoscopic intervention in challenging foreign body cases.