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Received date: 03/05/2025 Published date: 23/06/2025 Case Report

Case Report: Gastric Outlet Obstruction Secondary to Ingested Foreign Body in a 67-Year-Old Male

Brian Kenny*

Department of Gastrology, Bergen Street, Newark, NJ, United States.

*Corresponding author

Brian Kenny, Department of Gastrology, Bergen Street, Newark, NJ, United States.

DOI: 10.55920/JCRMHS.2025.11.001490

Introduction

Foreign body ingestion in adults is uncommon and often associated with psychiatric disorders, substance use, or accidental ingestion [1]. Gastric outlet obstruction caused by ingested coins is a rare clinical finding, particularly in older adults [2].

Case Presentation

A 67-year-old male with a medical history of congestive heart failure (CHF), gastroesophageal reflux disease (GERD), and polysubstance abuse presented to the emergency department with mid- to upper-sternal chest pain ongoing for approximately one day. During his evaluation, he also endorsed a new onset of left lower quadrant abdominal pain and post-prandial vomiting.

Vital signs were stable, and physical examination was non-contributory except for mild tenderness in the left lower quadrant. Laboratory investigations, including cardiac enzymes and complete blood count, were grossly unremarkable.

A CT scan of the abdomen and pelvis was performed to evaluate the abdominal pain, which revealed a gastric outlet obstruction secondary to a metallic foreign body (Figures 1-3). On further questioning, the patient admitted to accidentally swallowing four quarters during a magic trick.

Gastroenterology was consulted, and the patient underwent endoscopy with successful removal of the coins. The procedure was uncomplicated, and the patient had no immediate post-procedural complications.

Figure 1: Coronal view of metallic foreign body at the level of the pylorus.

Figure 2: Sagittal view of metallic foreign body at the level of the pylorus.

Figure 3: Transverse view of metallic foreign body at level of the pylorus.

Discussion

Foreign body ingestion leading to gastric outlet obstruction is rare in adults and often requires a high index of suspicion [3]. The patient’s polysubstance use history and the unusual context of the ingestion (a magic trick) highlight the importance of thorough history-taking in atypical presentations.

Conclusion

This case underscores the need to consider foreign body ingestion in the differential diagnosis of gastrointestinal symptoms in patients with risk factors such as substance abuse. Prompt imaging and endoscopic intervention can lead to successful resolution without complications.

References

Ambe P, Weber SA, Schauer M, Knoefel WT (2012). Swallowed foreign bodies in adults. Dtsch Arztebl Int. Dec;109(50):869-75. Epub 2012 Dec 14. PMID: 23293675; PMCID: PMC3536040.
Then EO, John F, Catalano C, Lopez M, Gaduputi V. An unexpected surprise: Delayed gastric outlet obstruction from coin ingestion.
Washburn P (2002). Substance use disorders: approaching the patient traditional history and physical, or screening? Occup Med. Jan-Mar;17(1):67-78, iv. PMID: 11726337.Clin Pract. 2019 May 7;9(2):1153. PMID: 31205642; PMCID: PMC6547025.

Journal of Clinical Case Reports, Medical Images and Health Sciences (ISSN 2832-1286) is a peer-reviewed journal dedicated to publishing clinical images from all sectors of medicine. The goal of this magazine is to disseminate information about new discoveries and treatments in science and medicine.

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