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Abstract
Gastric outlet obstruction (GOO) is characterized by postprandial vomiting due to mechanical obstruction. Rarely it can occur due to ingestion of a foreign body. Most cases of foreign body ingestion are benign, with passage of the ingested object into the stool with no clinical sequelae. We describe a case of an 80-year-old woman with GOO occurring secondary to ingestion of two coins (American quarters). Rarely will such a small object cause a true gastric outlet obstruction. To our knowledge this makes the second such case reported in the medical literature.
Highlights
Any intrinsic or extrinsic obstruction at the pylorus will result in gastric outlet obstruction (GOO)
Does foreign body ingestion cause GOO because most foreign bodies traverse the gastrointestinal tract without causing obstruction
The patient was transferred to the endoscopy suite to undergo esophagogastroduodenoscopy (EGD), which showed two coins (American quarters) obstructing the pylorus with underlying circular mucosal indentation and superficial non-bleeding ulceration
Summary
Any intrinsic or extrinsic obstruction at the pylorus will result in gastric outlet obstruction (GOO). Does foreign body ingestion cause GOO because most foreign bodies traverse the gastrointestinal tract without causing obstruction. Patient was tolerating oral intake till the day of presentation. A recent computed tomography (CT) scan of the abdomen, showed a foreign body of the stomach (Figure 2). The patient was transferred to the endoscopy suite to undergo esophagogastroduodenoscopy (EGD), which showed two coins (American quarters) obstructing the pylorus with underlying circular mucosal indentation and superficial non-bleeding ulceration. The pylorus was traversed and duodenum intubated after removal of the coins with a Roth net (Figure 3). During her stay in the hospital the patient tolerated oral diet and was safely discharged back to the nursing home
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