There is scant literature describing inadvertent ingestion of insects visualized during endoscopy.1,2 Previously described insects include ants, wasps, bees, yellow jackets, and cockroaches. We present a case of a 55-year-old male with a normal colonoscopy except for the discovery of a lifeless winged insect between folds of the transverse colon (Figure 1). In the image, the insect is ventral side up on the colon lining. Two compound eyes and abdomen are visible, but the thorax and portions of the wings are overexposed. Six legs can be discerned, and the insect had roughly a 6-mm craniocaudal length and a 12-mm wingspan. The image was later identified by an entomologist as a moth belonging to order Lepidoptera. Moths typically have scales covering the body and wings, but these scales are easily removed when exposed to an acidic environment. A loss of these scales explains the whitish coloration of the moth, as most of the pigmentation is found on the scales. Although these ingestions are of little consequence to the patient, they are quite rare and may even be startling to the endoscopist. To our knowledge, this is the first case of a moth described within the gastrointestinal tract.
Figure 1. Winged insect noted in the transverse colon during routine colonoscopy.
Author contributions: BB Patel, CM Andrade, and MJ Lajeunesse wrote and edited the manuscript. R. Geerken provided endoscopic images and reviewed and edited the final manuscript. BB Patel is the article guarantor.
Financial disclosure: None of the authors received financial support for the manuscript or express any personal or financial conflicts of interest.
Informed consent was obtained for this case report.
Correspondence: Brijesh B. Patel, Division of Digestive Diseases and Nutrition, University of South Florida Morsani College of Medicine, 12901 Bruce B. Downs Blvd., MDC 82, Tampa, FL 33612 (BPatel10@health.usf.edu).
Received: December 20, 2013; Accepted: February 18, 2014
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