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JAMA Surgery Clinical Challenge
January 4, 2017

An Unusual Cause of Small-Bowel Obstruction

Author Affiliations
  • 1Department of General Surgery, Shaare Zedek Medical Center, Hebrew University School of Medicine, Jerusalem, Israel
JAMA Surg. Published online January 4, 2017. doi:10.1001/jamasurg.2016.4959

A 43-year-old man with generally good health presented to the emergency department with sudden onset of cramps and abdominal pain. For the past year, the patient had been investigated for hypochromic microcytic anemia. As part of the investigation, he underwent an esophagogastroduodenoscopy and a colonoscopy, which revealed a normal-looking bowel with no obvious source of bleeding visualized. Further investigation involved capsule endoscopy, which was ingested 3 days prior to his emergency department admission. The patient claimed not to have passed a bowel movement containing the capsule.

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