RESUMEN
Gastric nodules (polyps) are a common finding in routine endoscopic procedures. Uncommonly, gastric nodules turn out to be lipid-filled waxy lesions called xanthomas. In this case report, we discuss a rare incidence of a gastric nodule turning out to be a xanthoma in a 50-year-old male patient. Xanthomas of the GI tract occur by the exact mechanism as their cutaneous counterpart and are relatively uncommon. A 50-year-old male with a past medical history of gastroesophageal reflux disease (GERD), hyperlipidemia, and constipation presented to our hospital with a chief complaint of epigastric discomfort, bloating, and gastric reflux, all starting the night before admission. Gastroenterology was consulted, and they performed an esophagogastroduodenoscopy (EGD) during the admission due to the patient's age and long history of GERD. EGD showed mild gastritis and xanthelasma. The patient's upper GI symptoms improved. All other workups were negative. Right upper quadrant (RUQ) US performed showed hepatic steatosis. With lifestyle changes, the patient's alkaline phosphatase returned to normal. After a month of medical management, GERD symptoms reoccurred. Repeat EGD was performed, and xanthomatous aggregates were shown, suggesting xanthoma. Upper GI symptoms continued. Gastric xanthomas are a rare occurrence. Most xanthomas in the upper GI tract are located in the stomach and have various causes. The risk for malignancy is low; these lesions are commonly confused for malignancies, prompting biopsy and histology. Overall, xanthomas are rare findings with a sinister look but benign results.
RESUMEN
Foreign body ingestion is a common medical emergency that can affect individuals of all ages and can be caused by various factors, including accidental ingestion, psychiatric disorders, intellectual disabilities, and substance abuse. The most common site for foreign body lodgment is the upper esophagus, followed by the middle esophagus, stomach, pharynx, lower esophagus, and duodenum. This article provides a case report of a 43-year-old male patient with a history of schizoaffective disorder and an indwelling suprapubic catheter who presented to the hospital due to foreign body ingestion. After examination, a metal clip from his Foley catheter was found lodged in his esophagus. The patient was intubated for the procedure, and an emergent endoscopic removal was performed to remove the metallic Foley component. No postoperative complications were observed, and the patient was successfully discharged. This case highlights the importance of considering foreign body ingestion in patients with chest pain, dysphagia, and vomiting. Prompt diagnosis and treatment are crucial to prevent potential complications such as perforation or gastrointestinal tract obstruction. The article also emphasizes the need for healthcare providers to know the different risk factors, variations, and common sites for foreign body lodgment to optimize patient care. Furthermore, the article highlights the importance of multidisciplinary care involving psychiatry and surgery to provide comprehensive care to patients with psychiatric disorders who may be at higher risk for foreign body ingestion. In conclusion, foreign body ingestion is a typical medical emergency that requires prompt diagnosis and treatment to prevent complications. This case report highlights the successful management of a patient with foreign body ingestion and emphasizes the importance of multidisciplinary care to optimize patient outcomes.