A Quarter Costing More Than 25 Cents: A Case of Recurrent Bowel Obstruction Caused by A Coin

George Khoudari MD¹*, Yazan Samhouri MD², Surinder Devgun MD³, Kenneth J. Vega MD⁴ and Tarun Kothari MD³

Received:October 11, 2019;   Published:October 16, 2019

DOI: 10.32474/CTGH.2018.02.000145

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Abstract

We report a patient with history of Crohn’s disease presenting with recurrent SBO; this is a common scenario for Crohn’s patients, as the disease process causes scarring and narrowing of the bowel, which can result in obstruction. Our patient had multiple emergency visits, courses of steroids, and was under consideration for biologic treatment aimed at apparent recurrent Crohn’s exacerbations while the true problem was a quarter causing symptomatic partial obstruction. Differential diagnosis of foreign body should be considered in cases of SBO, first or recurrent, where the cause is unclear. Extracting the quarter by ileoscopy resulted in an excellent patient outcome.

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