Intentional nail ingestion with caecal impaction: colonoscopic removal using a cap-assisted technique

Most foreign body ingestions in adult patients pass spontaneously while sharp objects often require endoscopic intervention. Endoscopic foreign body removals are usually performed in the upper gastrointestinal (GI) tract, with few reports involving the lower GI tract. We present a case of a woman with recurrent nail ingestion who presented with abdominal pain after swallowing multiple nails. Initial conservative management demonstrated progressive migration, with eventual clustering near the ileocaecal valve. In this case, a cap-assisted colonoscopy was successfully used to remove all ingested nails.