ENDOSCOPIC REMOVAL OF A COLONIC FOREIGN BODY USING A LOOP CUTTER DEVICE

Foreign body ingestion is a common event in childhood but can also happen in adulthood, usually occurring accidentally during a meal. The authors report the case of a 61 year-old female, with no relevant personal history, who was sent to the emergency department due to a foreign body lodged in the sigmoid colon that was identified on an outpatient colonoscopy performed due to lower abdominal pain and episodic fever in the last 3 months. The physical examination and laboratory tests were unremarkable. An abdominal computed tomography confirmed a foreign body with 46 × 5 mm on the rectosigmoid junction, associated with colic wall thickening and densification of the surrounding fat, with no evidence of fluid collections nor intraperitoneal free air. Endoscopic removal was attempted but the foreign body had its ends lodged into the colonic wall (diverticula area), with inflammatory signs and a small quantity of purulent drainage and it was decided to hospitalize the patient and start intravenous antibiotics. Endoscopy was repeated under general anesthesia two days later. A loop cutter device was used to cut the foreign body, with extraction of the two ends with grasping forceps. The sites of previous contact with the colic wall were closed with endoclips. The patient was discharged five days later without any complaints. The authors highlight the therapeutic innovation presented in this case, where an alternative use of a device enabled a safe and minimally invasive resolution and emphasize the excellent iconography collected on video.