Abstract
Foreign body ingestion (FBI) is a common clinical presentation, with most cases occurring in children. While accidental FBI in adults is less frequent, it is often associated with psychiatric conditions or substance use disorders. Magnet ingestion is particularly concerning due to the risk of pressure necrosis, perforation, and fistula formation, yet reports of magnet retention in adults are exceedingly rare. We describe a 45-year-old male with a history of depression and substance use disorder who presented with a three-week history of progressive abdominal pain, nausea, bloating, and foul-smelling belching. Imaging revealed a radiopaque foreign body in the distal gastric antrum, later identified as a 2.5 cm metallic disc-shaped magnet. Notably, a prior CT scan performed two years earlier had documented the same object, which the patient had presumed to be a dental filling and expected to pass spontaneously. Esophagogastroduodenoscopy (EGD) successfully retrieved the magnet using a Roth net, with immediate symptom resolution. This case is unique due to the prolonged asymptomatic retention of a magnet for two years before the onset of gastric outlet obstruction symptoms. While most foreign bodies pass spontaneously, endoscopic retrieval is warranted for magnets to prevent potential complications. The prolonged retention without perforation or obstruction highlights the role of anatomic location and object characteristics in determining outcomes. To our knowledge, this is the first reported case of successful endoscopic removal of a long-retained magnet in an adult using a Roth net. This case underscores the importance of considering FBI in the differential diagnosis of unexplained gastrointestinal symptoms, particularly in high-risk patients. Early recognition and intervention are crucial to prevent severe complications. Endoscopic removal remains a safe and effective strategy even for delayed presentations, emphasizing the need for clinical vigilance in cases of unwitnessed FBI.