Shell in the rectum

Description

A 67-year-old man with Down syndrome with intellectual disability presented with fever and cough. He denied abdominal pain or any change in bowel movement. His abdominal examination was unremarkable. A contrast-enhanced CT of the chest and abdomen performed for the fever work-up incidentally revealed a sharp-edged foreign body in the rectum without perforation (figure 1, online . A colonoscopy disclosed a conch shell, 5 cm in length, caught in the rectum (figure 2). Further history clarified that he mistakenly swallowed the chopstick rest made with a shell at a restaurant in Ishigaki Island, Okinawa, Japan. His fever was attributed to pneumonia, and after intravenous antibiotic therapy for several days the fever remitted. He was transferred to his residential facility. He was concluded as having swallowed shell, which transferred to the rectum after his swallowing.

Figure 1

Pelvic CT showing a sharp-edged foreign body.

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