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Diospyrobezoar as a Cause of Small Bowel Obstruction

2012; Karger Publishers; Volume: 6; Issue: 3 Linguagem: Inglês

10.1159/000343161

1662-0631

Andréia Padilha Toledo, Fernanda Hurtado Rodrigues, Murilo Rocha Rodrigues, Daniela Tiemi Sato, Ronaldo Nonose, Enzo Fabrício Nascimento, Carlos Augusto Real Martinez,

Abdominal Surgery and Complications

Phytobezoar, a concretion of indigestible fibers derived from ingested vegetables and fruits, is the most common type of bezoar. Diospyrobezoar is a subtype of phytobezoar formed after excessive intake of persimmons (Diospyros kaki). We report the case of a diabetic man with a 5-day history of abdominal pain after massive ingestion of persimmons who developed signs of complicated small bowel obstruction. The patient had a previous history of Billroth II hemigastrectomy associated with truncal vagotomy to treat a chronic duodenal ulcer 14 years earlier. Since intestinal obstruction was suspected, he underwent emergency laparotomy that revealed an ileal obstruction with small bowel perforation and local peritonitis due to a phytobezoar that was impacted 15 cm above the ileocecal valve. After segmental intestinal resection, the patient had a good recovery and was discharged on the 6th postoperative day. This report provides evidence that diospyrobezoar should be considered as a possible cause of small bowel obstruction in patients who have previously undergone gastric surgery.