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doi:10.1111/jgh.12820
E D U C AT I O N A N D I M A G I N G
Gastrointestinal: Heavy stomach
Figure 1 Cervical and abdominal X-rays: metal plate in the oropharynx and metal gastric bezoar.
Figure 2 5 cm.
Figure 3
Endoscopic view of the metal gastric bezoar.
Figure 4
Foreign bodies removed through surgery.
Endoscopic view of the oropharyngeal metal plate measuring
A 54-year-old woman with a history of paranoid schizophrenia and alcohol abuse was brought to the Emergency Department after intentional ingestion of foreign objects for several weeks. She complained of dysphagia and abdominal discomfort for the last week, and physical examination revealed a soft but distended abdomen. Cervical and chest radiographs showed a 47-mm round metal plate in the oropharynx/upper esophagus (Fig. 1), and on plain abdominal film a big, metal-density, gastric bezoar was evident (Fig. 1). On upper endoscopy, we were able to retrieve the metal plate from the epiglottic vallecula (Fig. 2) and to confirm the presence of the metal gastric bezoar consisting of multiple coins, drills, and screws (Fig. 3). Attempts to endoscopically remove the gastric foreign bodies were not performed because of its enormous size.
The patient was submitted to open surgical gastrostomy with multiple foreign body removal (Fig. 4), and her recovery was uneventful. Contributed by F Vilas-Boas,* M Marques,* F Baldaque-Silva,* E Barbosa,† A Taveira-Gomes† and G Macedo* Departments of *Gastroenterology and † Surgery, Centro Hospitalar de São João, Porto, Portugal
Journal of Gastroenterology and Hepatology 30 (2015) 3 © 2014 Journal of Gastroenterology and Hepatology Foundation and Wiley Publishing Asia Pty Ltd
3
doi:10.1111/jgh.12820
E D U C AT I O N A N D I M A G I N G
Gastrointestinal: Heavy stomach
Figure 1 Cervical and abdominal X-rays: metal plate in the oropharynx and metal gastric bezoar.
Figure 2 5 cm.
Figure 3
Endoscopic view of the metal gastric bezoar.
Figure 4
Foreign bodies removed through surgery.
Endoscopic view of the oropharyngeal metal plate measuring
A 54-year-old woman with a history of paranoid schizophrenia and alcohol abuse was brought to the Emergency Department after intentional ingestion of foreign objects for several weeks. She complained of dysphagia and abdominal discomfort for the last week, and physical examination revealed a soft but distended abdomen. Cervical and chest radiographs showed a 47-mm round metal plate in the oropharynx/upper esophagus (Fig. 1), and on plain abdominal film a big, metal-density, gastric bezoar was evident (Fig. 1). On upper endoscopy, we were able to retrieve the metal plate from the epiglottic vallecula (Fig. 2) and to confirm the presence of the metal gastric bezoar consisting of multiple coins, drills, and screws (Fig. 3). Attempts to endoscopically remove the gastric foreign bodies were not performed because of its enormous size.
The patient was submitted to open surgical gastrostomy with multiple foreign body removal (Fig. 4), and her recovery was uneventful. Contributed by F Vilas-Boas,* M Marques,* F Baldaque-Silva,* E Barbosa,† A Taveira-Gomes† and G Macedo* Departments of *Gastroenterology and † Surgery, Centro Hospitalar de São João, Porto, Portugal
Journal of Gastroenterology and Hepatology 30 (2015) 3 © 2014 Journal of Gastroenterology and Hepatology Foundation and Wiley Publishing Asia Pty Ltd
3
