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An Unusual Finding of a Ladybug on Screening Colonoscopy

Tahan, Veysel MD, FACP, FACG, FESBGH1; Tran, Ky-Dieu MD1; Yousef, Mohamad A. MD1; Daily, Francis E. MD1; Uraz, Suleyman MD1

doi: 10.14309/crj.0000000000000174

1Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Missouri, Columbia, MO

Correspondence: Veysel Tahan, MD, Department of Internal Medicine, Division of Gastroenterology and Hepatology, University of Missouri, Columbia, MO 65212 (

Received March 13, 2019

Accepted June 17, 2019

Online date: August 15, 2019

This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

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A ladybug was found in the transverse colon during screening colonoscopy of a 59-year-old man with no comorbidities (Figure 1). More than 6,000 Coccinellidae species described are commonly known as ladybugs in North America and ladybirds elsewhere in the English-speaking world. Ladybugs are cherished for being pretty, harmless, and even beneficial friends of farmers. Our ladybug “Harmonia axyridis, a multicolored Asian-type species, was imported to North America in the early 1900s to control pest populations. Their red-orange to dull cream colors are particularly eye catching. They hibernate during the winter. Light-colored homes in wooded areas attract their attention. Bug ingestions are rarely reported but can occur even during sleep. The patient's colonoscopy preparation was 1 gallon of polyethylene glycol the evening before colonoscopy, and the colonoscopy examination was otherwise normal. His colonoscopy preparation may have helped the bug to escape from digestive enzymes in the stomach and upper small intestine.

Figure 1

Figure 1

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Author contributions: All authors contributed equally to manuscript creation. V. Tahan is the article guarantor.

Financial disclosures: None to report.

Informed consent was obtained for this case report.

© 2019 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of The American College of Gastroenterology.