The presence of an intra-abdominal foreign body left after surgery may cause a medico-legal problem between surgeon and patient especially if there is a complication. 

A CT had been previously performed for this patient after the surgical procedure. Although the foreign body was visible it had not been reported by the radiologist as it was considered to be a surgical artefact from the anastomosis suture.

Had an abdominal x-ray been performed the diagnosis would have been immediately obvious, although generally plain films have limited utility in the setting of abdominal pain. 

This case shows us the importance of 3D reconstruction in the analysis of postoperative intra-abdominal metallic foreign bodies since it is basically assumed that metallic clips are often used. Also in CT evaluation of post-operative patients, one must take notice of all "Surgical never events" including metallic or other retained foreign objects.

Additional Contributors: Z. Boudiaf M.D, R. Bouguelaa M.D