Extraction of a perigastric foreign body using a lumen-apposing metal stent

Lumen-apposing metal stents (LAMS) were initially developed to drain perigastric pancreatic necrotic collections and perform endoscopic necrosectomy.

We report the case of a man hospitalized for a 4-cm infected antral perigastric collection secondary to a fishbone that had perforated the gastric antrum ([Fig. 1], [Video 1]). Upper gastrointestinal endoscopy showed a bulging collection in the prepyloric antrum ([Fig. 2]). Given the location of the collection, its size, and the presence of a foreign body within it, we first performed endoscopic cystogastrostomy using a 15×15 mm LAMS ([Fig. 3]). A second upper gastrointestinal endoscopy was performed 7 days later to extract the fishbone through the LAMS ([Fig. 4]). The procedure was successful. No complication occurred.

Extraction of a perigastric foreign body using a lumen-apposing metal stent.Video 1

Fig. 1 Initial CT scan showing an antral perigastric collection measuring 4 cm in diameter and containing a hyperdense linear image suggestive of a bone or fishbone foreign body.

Fig. 2 Upper gastrointestinal endoscopy showing a bulging collection in the prepyloric antrum.

Fig. 3 Cystogastrostomy using a 15 × 15 mm lumen-apposing metal stent (LAMS).

Fig. 4 Fishbone extraction through the LAMS using foreign-body forceps.

This endoscopic minimally invasive approach avoided surgery, and the patient was discharged from hospital the day after the fishbone extraction. The 6-month follow-up period was uneventful.

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Publication History

Article published online:
29 May 2024