We report the case of a 76-year-old woman, without alcoholic habits, who came to the emergency department with nausea, vomiting and intense abdominal pain of 12 hours duration, located in the epigastrium, irradiated to the back.
Abdominal pain was present in the epigastric region.
Laboratory tests showed leukocytosis, amylase 1.193 U/l, lipase 16.900 U/l, triglycerides and calcemia normal.
Abdominal CT showed edema of the head of the pancreas and absence of gallstones, confirmed by abdominal ultrasound.
She was admitted to our service with a diagnosis of acute acalculous pancreatitis.
She started absolute fasting, abdominal pain treatment with analgesics and intravenous fluid replacement.
The patient showed clinical and laboratory improvement after 48 h.
A 3 cm hyperechogenic lineal foreign body was detected in an ultrasound performed before discharge between the posterior wall of the gastric antrum and the cefarium pancreas region.
This echographic finding was confirmed by endoscopic ultrasound.
Endoscopy revealed an edematous area in the posterior wall of the gastric antrum, with central depression, presumed point of entry of the foreign body into the gastric wall.
The case was discussed with the surgeon, but due to the rapid clinical improvement and the patient's desire, an expectant attitude was adopted.
Ultrasonography was repeated after 6 months, verifying the regression of the foreign body, being embedded in the gastric wall without evident contact with neighboring structures.
No symptomatic recurrence was observed.
