A 27-year-old woman with a history of schizoaffective disorder presented from an inpatient psychiatric facility with an acute onset of nausea, vomiting, abdominal pain, and early satiety. On examination, vital signs were stable. Abdomen was distended and diffusely tender to palpation but without peritoneal signs. Computed tomography scan showed multiple, well-circumscribed lesions of varying density within the gastric body but no evidence of perforation or obstruction (Figure A). Upper endoscopy was performed. The esophagus was normal in appearance. Upon entering the stomach, there were numerous crayons layered in the gastric fundus and gastric body (Figure B). An overtube was placed into the stomach under endoscopic guidance, and a total of 81 full-size and intact crayons, crayon wrappers, and a pen were removed with a snare (Figure C). Guidelines on foreign bodies in the stomach recommend urgent removal of sharp or long (>5 cm length) and/or wide (>2.5 cm diameter) objects with surgical consultation if the foreign body is unable to be retrieved endoscopically. The patient did well after the procedure and was discharged back to inpatient psychiatric facility.
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Publication history
Published online: April 21, 2022
Accepted:
April 8,
2022
Received:
March 31,
2022
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Conflicts of Interest: The authors disclose no conflicts.
Funding: The authors report no funding.
Ethical Statement: The corresponding author, on behalf of all authors, jointly and severally, certifies that their institution has approved the protocol for any investigation involving humans or animals and that all experimentation was conducted in conformity with ethical and humane principles of research.
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