We present a patient who experienced classic symptoms of acute intestinal obstruction. He attempted to relieve the symptoms by swallowing a mixture of herbs and cowrie.

This undoubtedly worsened his symptoms and he was finally brought to the hospital . After crystalloid resuscitation and iv antibiotics , patient was counselled for laparotomy.

The following are the intraoperative findings

An impacted cowrie found at a narrowed segment of the small bowel about 60cm proximal to the ICJ

Dr Richard Ametih and the surgical team ,

St Benito Menni Hospital