Background: Foreign body (FB) ingestion is an endoscopic emergency seen globally. The object swallowed could be food, especially meat bolus impaction with background luminal narrowing, coins commonly in children, and fish bone or some isolated sharps usually in psychiatric patients in an attempted suicide. Impaction site depends on the size, shape, and type of the FB. The most common lodgement site is upper esophagus, then the middle esophagus, stomach, pharynx, lower esophagus, and the duodenum. Often, a FB in the stomach will pass within 4–6 days. In this report, we present a case of accidental bottle cover ingestion and successful endoscopic retrieval.
Case Report: A 37-year-old civil servant was referred for gastroscopy on an account of ingestion of bottle cover 3-months prior to presentation. The incident happened while licking an overflowing fermented drink (Fura da Nono) in a tightly closed plastic container where the cover forcefully popped into his throat. Had few episodes of hemoptysis, but no breathless. There was intermittent dysphagia and epigastric pain radiating to the shoulder. There was no vomiting, no history of psychiatric illness, the use of illicit drugs, or similar occurrence in the past. Abdominal x-ray showed radio-opaque object in the stomach. Endoscopy revealed about 3 × 3 cm mucous-coated bottle cap in the stomach with hyperemia around the area of basement, not embedded. The bottle cap was removed using Roth Net FB retriever.
Discussion: FB ingestion more commonly occurs in males. About 20% of adults who accidentally ingest FB do so while eating. This is the case with our index case who forcefully swallowed bottle cap while licking a spilling drink. Contrary to the common transit for most FB in stomach, our index case kept it for over 12 weeks, which may be responsible for the inflammatory changes seen on endoscopy. The over stay may be due to the size of FB, which is too big for the pylorus to pass.
Conclusion: Endoscopic removal might be feasible in carefully selected patients with an old FB in the stomach without the need for surgery.
Keywords: Endoscopic removal, foreign body, plastic cover