Pseudo bezoar in an elderly man

Abstract

Indigestible intra-gastric foreign bodies are encountered in the mentally deranged, transporters of illicit drugs or those desiring weight control. They are often complicated by obstruction, migration, or perforation. Pseudobezoars are indigestible objects introduced intentionally into the digestive system. They may be indicated in bariatric practice for control of obesity. We present an 87-year-old man managed for a 2-year history of burning epigastric pain, aggravated by lying down and relieved by antacids. He had associated reflux symptoms for which he adopted lifestyle modifications. He had an upper gastrointestinal endoscopy which showed a stone attached to the anterior wall of the body of the stomach with associated pseudo-pouch formation. Mucosal overgrowth on the stone could be noted. Attempts at endoscopic retrieval failed as the stone could not be dis-impacted from its lodgement in a mucosal pouch. He had a laparotomy and gastrotomy for retrieval. A piece of stone, identified as granite, which measured 2 × 2 × 2.5 cm was retrieved from the stomach with accompanying formation of the mucosal pouch. Mucosal response, which may include overgrowth, could be an initial step in the migration of intra-gastric foreign bodies.