# Metal Bezoar-Induced Gastrointestinal Obstruction: A Rare Clinical Presentation

## TL;DR

A rare case of metal bezoar causing gastrointestinal blockage in a substance-abusing patient required surgery due to high complication risks.

## Contribution

Highlights the clinical management and risks of metal bezoars, emphasizing multidisciplinary treatment approaches.

## Key findings

- Metal bezoars are rare and pose high risks of gastrointestinal perforation.
- Endoscopic removal is preferred, but surgery is needed for complex cases.
- Multidisciplinary care is essential to prevent recurrence and manage underlying disorders.

## Abstract

Bezoars are accumulations of indigestible or non-food material within the gastrointestinal tract, capable of causing obstruction, bleeding, or perforation. We report the case of a 25-year-old male patient with a history of chronic polysubstance abuse who presented with a one-month history of persistent vomiting, severe epigastric pain, and minimal tolerance to liquids. Abdominal radiography and computed tomography revealed metallic foreign bodies in the stomach and colon. Endoscopic removal was deemed unfeasible due to the size and characteristics of the objects; therefore, open surgery was performed with successful extraction. Metal bezoars, as in this case, are rare and carry a high risk of complications, particularly gastrointestinal perforation, due to the ingestion of sharp or bulky objects. Treatment should be individualized based on bezoar type, size, and location. Endoscopic removal is the first-line approach when feasible; however, surgical intervention is warranted in complex or high-risk cases. This case underscores the need for a multidisciplinary approach combining surgical management, complication prevention, and treatment of underlying psychiatric or substance use disorders to reduce recurrence and improve long-term outcomes.