When performing a colonoscopy, we must be prepared for anything. We never know what we may find, and in the case of an unusual finding, writing a detailed, descriptive report, accompanied by photographs, is essential. We present herein the case of a 38-year-old male, who underwent an outpatient colonoscopy to rule out an inflammatory disease. An insect was identified in the right colon at the level of the ileocecal valve (Fig. 1). It was extracted using a Roth Net® retrieval basket to prevent its fragmentation in the aspiration channel. Through the endoscopic image of the object, and after its extraction and external revision, a cockroach was identified. Upon close inspection, it was surprising to see the insect’s structure was intact, influenced by the patient having taken a preparation for the colonoscopy that accelerates bowel transit. When the patient awoke from the sedation, he was told of the finding. His reaction was one of astonishment, and he could not understand how it got there. In the literature, there are few cases describing findings of insects in the colon. In most cases, they end up in the gastrointestinal tract due to accidental ingestion of contaminated food, albeit there are countries in the world where insects are part of the diet. We were unable to determine how the cockroach entered our patient’s colon, but it serves as a reminder to us that the most unexpected things can be revealed in a colonoscopy.

Figure 1.

Cockroach in the right-sided colon.