This is what worked for me. If you have the oid, then all you need to do is:

<?php
$pdo = new PDO($dsn, $user, $pass);
$pdo->beginTransaction();
$data = $pdo->pgsqlLOBOpen($oid, 'r');

header("Content-Type: $mime");
// any other headers...

fpassthru($data);  // echo stream_get_contents($data); also works
?>

The beginTransaction() is required, if you want to $pdo->commit() (it's not required) then do it after the fpassthru.

On a side note, those using Zend Framework can call getConnection() on the standard PDO database object which will get them the $pdo object as above. Then just remember to disableLayout() and setNoRender() as necessary.

Also remember that fread() will only parse the first 8192 bytes from the stream. Use..

<?php
$data = stream_get_contents($stream);
?>

.. if you have a larger output to parse.

The above example is missing some data. After spending several hours trying to get it to work in vain, Jeff Davis from the PostgreSQL channel on IRC (freenode) figured out what was missing.

The below example will work, but you have to insert the MIME type and file size of the large object that you are storing, so you can use that data for extraction.

<?php
$db = new PDO('pgsql:dbname=test host=localhost', $user, $pass);
$db->setAttribute(PDO::ATTR_ERRMODE, PDO::ERRMODE_EXCEPTION);
$db->beginTransaction();
$stmt = $db->prepare("SELECT oid, blob_type, filesize FROM BLOBS WHERE ident = ?");
$stmt->execute(array($some_id));
$stmt->bindColumn('oid', $lob, PDO::PARAM_LOB);
$stmt->bindColumn('blob_type', $blob_type, PDO::PARAM_STR);
$stmt->bindColumn('filesize', $filesize, PDO::PARAM_STR);
$stmt->fetch(PDO::FETCH_BOUND);
$stream = $pdo->pgsqlLOBOpen($lob, 'r');
$data = fread($stream, $filesize);
header("Content-type: $blob_type");
echo $data;
?>

Also fpassthru() will just give this result: Warning: fpassthru(): supplied argument is not a valid stream resource in ...

Use echo or print instead.