Bezoar mit echter und vorgetäuschter Komplikation

Abstract

A 64-year-old patient with lower abdominal complaints "come un sasso nel stòmaco" was admitted as an emergency with acute upper gastrointestinal haemorrhage. There was a discrepancy between the clinically unremarkable abdomen and the large amounts of free air subdiaphragmatically on the left side as seen in the radiograph. Endoscopy did not contribute greatly due to presence of a large "coagulum". Surprisingly, at operation a huge phyto-bezoar measuring 15 x 8 x 8 cm, and a benign pressure ulcer in the great curvature were found. The perforation had only been mimicked, the air sickle was within the stomach and was demarcated by the round upper pole of the bezoar.