Gastric Pharmacobezoar of Mesalamine Tablets Retrieved Endoscopically

A 58-year-old man presented with complaints of epigastric pain for 2 years, recurrent vomiting containing stale food, and weight loss of 10 kg in the previous 3 months. He had been started on tablet mesalamine at a secondary care center for suspicion of Crohn’s disease, but there was no improvement in his symptoms. Barium meal study suggested multiple oval-shaped filling defects in his stomach (Figure 1). Esophagogastroduodenoscopy revealed multiple tablets creating a pharmacobezoar in the body of stomach with pyloric stenosis (Figure 2). The scope was not negotiable beyond the pylorus. Tablets were removed with the help of a basket, and the patient was referred back to the surgery department where he underwent gastrojejunostomy to bypass the obstruction.