Case Report
Copyright ©2006 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Oct 7, 2006; 12(37): 6074-6076
Published online Oct 7, 2006. doi: 10.3748/wjg.v12.i37.6074
Intracolonic multiple pebbles in young adults: Radiographic imaging and conventional approach to a case
Mehmet Eryilmaz, Orkun Ozturk, Oner Mentes, Kenan Soylu, Murat Durusu, Köksal Oner
Mehmet Eryilmaz, Orkun Ozturk, Kenan Soylu, Murat Durusu, Köksal Oner, Gulhane Military Medical Academy, Department of Emergency Medicine Ankara, Turkey
Oner Mentes, Gulhane Military Medical Academy, Department of General Surgery Ankara, Turkey
Correspondence to: Oner Mentes, Gulhane Military Medical Academy, Department of General Surgery Ankara, Turkey.
Telephone: +90-312-3045015 Fax: +90-312-3045002
Received: March 30, 2006
Revised: April 22, 2006
Accepted: May 25, 2006
Published online: October 7, 2006

Most of the foreign bodies detected in adult gastrointestinal systems are accidentally swallowed pins. In this study, we presented a case with intracolonic multiple pebbles. A 20-year-old man was admitted to emergency surgery policlinic for abdominal pain for 2 d without any alleviation or aggravation. His upright plain abdominal radiographic imaging revealed about 30-40 overt dense opacities in lumen of colonic segments, with oval and well shaped contours, each approximately 1 cm x 1 cm in size. The multiplanar reconstructions and three-dimensional images combined with sectional screening showed that all pebbles had passed completely into the colon and no foreign bodies had remained in the ileal segments. On psychiatric assessment, he was found to have immature personality features, difficulty in overcoming stressors and adaptation disorder. He recovered by conservative management and radiographic monitoring applied during his follow-up. Thus, it can be concluded that, in differential diagnosis of abdominal pain in adult ages, though less frequently seen than in children, gastrointestinal system foreign bodies should always be kept in mind and it should be considered that ingestion of pebbles may be one of the factors contributing to abdominal pain particularly in young adults with psychiatric problems. In such cases suspected of having foreign bodies which cannot be detected by plain films, abdominal tomography can be an alternative for diagnostic imaging.

Keywords: Intracolonic multiple pebbles, Current approach, Radiographic imaging