Apple Core Unveiled: Malignant Colonic Obstruction Revealing an Unknown Rectosigmoid Neoplasm With Foreign Body Impaction

TL;DR

A 46-year-old man's chicken bone impaction revealed an unknown rectosigmoid tumor causing colonic obstruction, highlighting the link between foreign bodies and unexpected cancer detection.

Contribution

This case report presents a rare instance where foreign body impaction led to the early detection of rectosigmoid neoplasm in a younger individual.

Findings

An impacted chicken bone was found lodged in a previously unknown rectosigmoid tumor during surgery.

Anatomopathological analysis confirmed mucinous adenocarcinoma with clear margins and one metastatic lymph node.

The case emphasizes the importance of imaging and vigilance in diagnosing colorectal cancer in younger patients.

Abstract

This case report highlights a rare clinical scenario of a 46-year-old male presenting with constipation and fecaloid vomiting due to an impacted chicken bone within an unidentified rectosigmoid neoplasm, leading to acute malignant colonic obstruction. Emergent exploratory laparotomy revealed an impacted chicken bone lodged in a previously unknown rectosigmoid tumor. An anatomopathological examination revealed a mucinous adenocarcinoma with clear margins and one pericolic metastatic lymph node. The postoperative period was uneventful, and the patient was proposed for adjuvant chemotherapy. The abrupt onset of symptoms allowed for an early diagnosis, emphasizing the unexpected association between foreign body impaction and incidental malignant obstruction. This case underscores the complexity of managing foreign body ingestion in the gastrointestinal tract and emphasizes the crucial role of diagnostic imaging in surgical planning. Furthermore, it draws attention to the potential occurrence of colorectal cancer in younger individuals, emphasizing the necessity for clinical vigilance and screening strategies beyond conventional age recommendations.

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