Unexpected Marble‐Like Lesions in Patient With Acute Upper Abdominal Pain

A 52-year-old woman was admitted to the emergency department with acute upper abdominal pain 2 h later having lunch. Routine blood tests were normal and computed tomography was performed, which revealed multiple well-defined hyperdense marble-like lesions in the stomach and duodenum, accompanied by gastroduodenal distension from the stomach to second portion of the duodenum (Figure 1). Additionally, there was compression at the third portion of duodenum with aortomesenteric diameter of 5.7 mm (Figure 1), leading to a diagnosis of superior mesenteric artery syndrome. Oesophagogastroduodenoscopy performed the next day showed diffuse gastritis. On further enquiry, the patient had ingested Boba milk tea during her lunchtime 3 hours prior to her admission. Taken her temporal sequence of events, the marble-like lesions were likely to be the tapioca pearls in Boba tea. Superior mesenteric artery syndrome might be the cause of retention of tapioca pearls due to compression of the third portion of the duodenum. The calcified component of the tapioca pearls is attributed to the radio-opacity. With the growing popularity of Boba tea worldwide, similar accidental findings may become more common. This unexpected radiological finding of tapioca pearls could serve as a valuable learning experience for physicians who encounter similar cases in the future. (A) Coronal section of computed tomography shows multiple well-defined hyperdense marble-like lesions in the stomach and duodenum. (B) Transverse section of computed tomography shows that the aortomesenteric diameter is 5.7 mm (Less than 8 mm). The authors declare no conflicts of interest. The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.