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Chronic pyloric obstruction caused by Flammulina mushroom: A rare case report
Zhaohui Liu1, Ruinuan Wu2, Zepeng Wang1
1Department of Gastroenterology, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, China.
Rationale:
We report a rare case of chronic pyloric obstruction lasting 4 years. During the endoscopy examination, the cause was found to be foreign matter blocking the pylorus. We assessed the patient's medical history and ultimately considered chronic pyloric obstruction caused by blockage of the Flammulina mushroom.
Patient Concerns:
A man in his early 30 presented to the emergency department of the hospital due to recurrent vomiting for 4 years that had aggravated for 2 days.
Diagnoses:
Emergency CT indicated enlargement of the gastric cavity, numerous gastric contents in the gastric cavity, and suspicion of pylorus or duodenal bulb stenosis on imaging. Laboratory findings showed metabolic alkalosis and hypokalemia. When the gastroscope reached the antrum, the endoscopic doctor found a disc-shaped brown object (Flammulina mushroom) in the posterior wall of the posterior antrum.
Interventions:
A snare was used to remove the Flammulina mushroom through the endoscopy.
Outcomes:
The patient's gastric emptying completely resolved, and no vomiting symptoms recurred after 1 month of follow-up.
Lessons:
For young men with a history of digestive disease, when gastric retention occurs, doctors are more inclined to diagnose the obstruction caused by the ulcer based on their subjective consciousness. This is a case that did not follow this expectation. Some food without sufficient chewing couldn't be easily digested by gastric acid.
Insights
A rare case of chronic pyloric obstruction caused by a Flammulina mushroom was successfully treated with endoscopic removal. This highlights the importance of considering unusual causes of gastric outlet obstruction in young adults.
Area of Science:
- Gastroenterology
- Digestive Endoscopy
Background:
- Reports a rare instance of chronic pyloric obstruction persisting for four years.
- Investigates a case where foreign matter was identified as the cause of pyloric blockage.
Observation:
- A young adult male presented with a four-year history of recurrent vomiting, exacerbated over two days.
- Emergency CT revealed gastric distension and suspected pyloric stenosis; endoscopy identified a Flammulina mushroom obstructing the antrum.
Findings:
- Endoscopic snare removal of the Flammulina mushroom was performed successfully.
- The patient experienced complete resolution of gastric emptying and no recurrence of vomiting after one month.
Implications:
- Challenges typical diagnostic assumptions of ulcer-related obstruction in young men with gastric retention.
- Underscores the potential for undigested food, like poorly chewed mushrooms, to cause significant gastrointestinal obstruction.
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