Management of Persimmon Bezoars (Diospyrobezoars)

Dolan, Patrick A.; Thompson, Bernard W.

doi:10.1097/00007611-197912000-00010

Cited by 11 publications

(5 citation statements)

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“…Bezoars are collections or concretions of indigestible foreign material accumulating and coalescing in the gastrointestinal tract, usually the stomach [4] . Gastric bezoars occur after gastrectomy and can be found incidentally or upon evaluating symptoms such as indigestion.…”

Section: Discussionmentioning

confidence: 99%

Bezoar as a cause of jejunal afferent loop mass after pylorus preserving pancreaticoduodedectomy: A case report

Lee

2021

International Journal of Surgery Case Reports

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Introduction and importance Bezoars may occur in patients after undergoing gastric surgery. Most bezoars are discovered due to small intestine obstruction, causing acute abdomen. Case presentation A 44-year-old woman with a history of intraductal papillary mucinous tumor of the pancreas was initially treated with pylorus-preserving pancreaticoduodenectomy. Two years ago, she had intermittent abdominal pain with no noted abnormality on computed tomography (CT) scan and gastroscopy. During her follow-up, an abdominal CT scan revealed a 1.8-cm low-enhancing nodular tumor with minute central calcification at the afferent loop of the jejunum, later diagnosed as a jejunal tumor. Endoscopy helped determine the location and characteristics of the tumor. Endoscopic findings revealed a bezoar approximately 3 cm below the pancreaticojejunostomy and hepaticojejunostomy, at the end of the afferent loop of the jejunum. Removal using an endoscopic basket failed as the bezoar broke halfway. Residual suture material was found inside the bezoar. Since the size of the bezoar decreased, the procedure was discontinued to allow it to dislodge naturally. Clinical discussion Bezoars may be caused by gastric surgery, increased fiber diet, and psychiatric illness. As seen in this case, residual suture material caused bezoar formation. Bezoars mainly occur in the stomach and small intestines, but they can also occur in the afferent jejunal loop, as seen in this case. Conclusion Surgeons should be careful not to leave behind suture material during gastric surgery. However, bezoar formation should be considered in patients complaining of abdominal pain even if they did not undergo gastrectomy.

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Section: Discussionmentioning

confidence: 99%

Bezoar as a cause of jejunal afferent loop mass after pylorus preserving pancreaticoduodedectomy: A case report

Lee

2021

International Journal of Surgery Case Reports

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“…Patients with minor symptoms profit from medication therapy by enzymes (19). Cellulase is the only medical treatment of the symptoms, but bowel obstruction followed by this treatment is a complication effect due to bezoar dissolution passing through the stomach and trapping in the intestines (20). Endoscopic procedures are used for crushing and suction of mass.…”

Section: Discussionmentioning

confidence: 99%

Gastric Diospyrobezoar Mimicked Acute Appendicitis: A Case Report

Saatian

Shafii

Bayesh

et al. 2016

Thrita

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A phytobezoar is a concreted mass of undigested plant materials trapped in the gastrointestinal system and mostly in the stomach. A diospyrobezoar is a type of phytobezoar and is a rare condition; it is due to unripe persimmon ingestion. In this case, report, we recount the experience of a 26-year-old man who presented signs and symptoms of acute appendicitis, which was later diagnosed as a gastric diospyrobezoar. An appendectomy was done, but the symptoms were not resolved. This gastric phytobezoar was successfully removed through gastrotomy after a failed attempt in endoscopic fragmentation and removal. This report provides an overview of bezoars in patients with acute abdominal pain. A careful history with an emphasis on recent diet can be of great help in the diagnosis of similar cases.

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“…By far the most common cause is the persimmon (1,2). It has been recognized that phytobezoar formation is common after a gastric operation, and causes gastric ulceration, bleeding, and gastrointestinal obstruction.…”

Section: Index Words: Bezoarmentioning

confidence: 99%