Gastric Polyposis Due to Foreign Bodies and H. pylori Infection: Case Report and Literature Review.

Background and Clinical Significance: Foreign body ingestion represents an endoscopic emergency, with a risk of organ perforation of up to 35%, where increased prevalence was noticed among people with mental disorders and institutionalized patients. Case Presentation: The patient-male, 23 years old, and institutionalized for sequelae of infantile encephalopathy-was admitted for epigastric pain and hyperemetic syndrome that began 10 days earlier. Endoscopically, 12 hard plastic foreign bodies with sharp edges and sizes of 6-7 cm were identified, followed by extraction that was successfully performed in two sessions using a polypectomy snare and a Foreign Body Hood Protector. Additionally, multiple sessile exulcerated polypoid lesions were observed, measuring around 1-3 cm each, occupying the entire antrum. Histological examination showed inflammatory/regenerative elements, with features of moderate-to-high-grade dysplasia, while a rapid urease test for Helicobacter pylori infection was positive. As a consequence, the patient was administered triple eradication therapy. In addition, the patient presented marked features of hypereosinophilia and splenomegaly. Upon endoscopic reevaluation after 3 years and 8 months, no polyps were present and the H. pylori test was negative, while a complete and spectacular remission of both the hypereosinophilia and splenomegaly was observed.

Conclusions

This case illustrates that the development and progression of gastric polyposis may be caused by the coexistence of chronic mucosal irritation from foreign bodies and H. pylori infection, which is a rare association. H. pylori eradication and endoscopic removal of the foreign bodies resulted in significant mucosal improvement.