Korean J Gastrointest Endosc.  2008 Oct;37(4):276-279.

Endoscopic Removal of Small Bowel Bezoars using Colonoscopy through the Oral Approach

Affiliations
  • 1Department of Internal Medicine, Ewha Medical Research Institute,Ewha Womans University School of Medicine, Seoul, Korea. shimkn@ewha.ac.kr
  • 2Department of Surgery, Ewha Medical Research Institute,Ewha Womans University School of Medicine, Seoul, Korea.

Abstract

Bezoars are accumulations of foreign materials and foods in the gastrointestinal tract and can be the cause of small bowel obstruction. A bezoar usually begins as a gastric phytobezoar that migrates to the small bowel in patients who have undergone gastric surgery and have delayed gastric emptying. We report a case of diagnosed small bowel obstruction due to the presence of a persimmon phytobezoar (diospyrobezoar) in a patient with a history of gastric surgery. Abdomen-pelvis computed tomography demonstrated the presence of an air-containing localized lesion (5x3.5 cm), a suspicious bezoar in the jejunum. The gastroduodendoscopy failed to reach to the lesion but diospyrobezoars were found in the proximal jejunum at 120 cm from the upper incisors using a colonoscope inserted using the oral approach. Most of the bezoars were fragmented by a tripod and were removed with a snare. The patient was discharged after symptomatic improvement without surgery. We report this case with a review of the relevant literature.

Keyword

Bezoar; Intestinal obstruction
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