Cuerpo extraño intragástrico: una causa poco frecuente de dolor abdominal

A 54 year-old woman was admitted to the Neumology Service in our Hospital due to hemoptysis. Fifteen years ago she was diagnosed peptic ulcer, and received medical treatment with good evolution. During the present episode she suddenly suffered acute epigastric pain, not irradiated, not accompanied by nausea or vomiting and her injury worsened after food ingestion. Complete laboratory tests were carried out, with no abnormalities. Simple abdominal X-ray was anodyne, and ultrasound was informed as normal. We were commented this case and, considering the patient’s precedents, the decision was to run an upper endoscopy, which took place about 36 hours after the beginning of her symptoms. We could observe the presence of a thin long foreign body, penetrating gastric mucosa at both ends, located on prepyloric area (Fig. 1). It seemed to be a bone and mucosa presented incipient inflammatory reaction at impactation points. The foreign body was removed and we could see two small not complicated ulcerations (Fig. 2). The bone was a little chicken rib, about three centimeters long and had very sharpened ends. After these findings, a second look was made on the abdominal X-ray. Amore exhaustive study showed the presence of a small, long calcic image, about three centimeters long, located on upper right abdomen, which had not been detected in the first exams and seemed to be the chicken bone (Fig. 3). In the following hours the patient presented a good evolution, with no pain and normal oral feeding.