Similar in Size But Different in Detail Jong Jin Hyun 1,2 and Richard A. Kozarek 1 1 Digestive Disease Institute, Virginia Mason Medical Center, Seattle, Washington, and 2 Korea University College of Medicine, Seoul, Korea Question: A 67-year-old man presented with abdominal pain. The patient had a 10-year history of rather severe abdominal pain that occurred every 6 months and lasted for 1 week at a time. More recently, however, the pain evolved to occur weekly and lasted for 36 to 48 hours. These pains were located in the lower abdomen, increased over several hours, were colicky in nature, and invariably ended in multiple emesis. His only abdominal surgery was an appendectomy 13 years ago. He also had lost a total of 50 pounds of weight over the past 2 years. Therefore, computed tomography (CT) enterography was ordered to evaluate recurrent abdominal pain and unintentional weight loss. On CT enterography, streak artifact was noted in the cecum consistent with the presence of some metallic object (Figure A). On a scout image, a 24  9-mm, densely radiopaque ovoid foreign body could be observed in the right lower quadrant of the abdomen (Figure B) and was interpreted as a capsule endoscope in the cecum. What is this radiopaque metallic object seen in the abdomen? Look on page 614 for the answer and see the Gastroenterology web site (www.gastrojournal.org) for more information on submitting your favorite image to Clinical Challenges and Images in GI. Conflicts of interest The authors disclose no conflicts. © 2018 by the AGA Institute 0016-5085/$36.00 https://doi.org/10.1053/j.gastro.2018.01.048 CLINICAL CHALLENGES AND IMAGES IN GI Gastroenterology 2018;155:613–615