Atmani JE1*, Ismail Y1, Kousse ML1, Elfarouki A1, Errami AA1, Samlani Z1, Oubaha S2 and Krati K1
1Department of Hepato-Gastroenterology, Med VI Medical Center of Marrakech, Morocco
2Department of Physiology, Med VI Medical Center of Marrakech, Morocco
Ingestion of the foreign body is a frequent situation in Gastroenterology; however colonic localization remains very rare. The objective of this work was to report the exceptional case of a colonic foreign body revealed by sub-occlusive syndromes. This is a 65-year-old patient with no significant pathological history, who presented with Koenig's syndrome progressing against a background of deterioration of the general state with a periumbilical impasto on examination. The abdominal CT objectified a thickening of the transverse colon with foreign body at the level of the peritoneal fat making suspect a colonic perforation by clogged foreign body. Colonoscopy showed an impassable stenosis of the transverse colon, the anatomopathological study of colonic biopsies was in favor of granulomatous colitis, the patient therefore underwent colonic resection with endto- end anastomosis with good postoperative progress. An anatomopathological study of the operative resection part showed that it was a granulomatous colitis with a foreign body. In the absence of anamnestic orientation, the colonic localization of a foreign body poses a real problem of differential diagnosis with tumor, infectious and inflammatory pathologies. It can be revealed by complications such as occlusion or perforation where imaging plays a key role. Endoscopy always plays an essential diagnostic and therapeutic role in the care of ingested foreign bodies, thus limiting surgical morbidity, although this remains sometimes unavoidable, and the anatomopathological study highlights a granuloma with a constituted foreign body. Granulomatous colitis with a foreign body with clogged colonic perforation is a rarely reported situation and must henceforth be considered before any colonic symptomatology even in the absence of the anamnestic elements in favor such as our case in order to avoid the patient from the side effects and complications of heavy treatments.
Granulomatous colitis; Foreign body; Tumor process; Endoscopy; Surgery
Atmani JE, Ismail Y, Kousse ML, Elfarouki A, Errami AA, Samlani Z, et al. Granulomatous Colitis with Foreign Body Mimicking a Tumor Process: Case Report. Ann Clin Case Rep. 2020; 5: 1804.