Clin Endosc.  2013 Jul;46(4):399-402.

A Large-Sized Phytobezoar Located on the Rare Site of the Gastrointestinal Tract

• Yang JE
• Ahn JY
• Kim GA
• Kim GH
• Yoon DL
• Jeon SJ
• Jung HY
• Kim JH

Abstract

Bezoars are concretions of undigested material and are most often observed in the stomach. They can occur at any site in the gastrointestinal tract; however, duodenal localization is very rare. We report the case of a 71-year-old male who had undergone subtotal gastrectomy with gastroduodenostomy and experienced severe epigastric discomfort, abdominal pain, and vomiting for a few days. An approximately 7x8 cm-sized mass was found on an abdominal computed tomography scan. On following endoscopy, a large bezoar was revealed in the duodenum and was removed using an endoscopic removal technique, assisted by a large amount of Coca-Cola infusion.

Keyword

Endoscopy; Gastrectomy; Phytobezoar

MeSH Terms

Abdominal Pain
Bezoars
Duodenum
Endoscopy
Gastrectomy
Gastrointestinal Tract
Humans
Male
Stomach
Vomiting

Figure

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  Fig. 1 (A) Abdominal computed tomography scan shows a duodenal mass considered to be a bezoar (white arrow). (B) Axial view (white arrow).

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  Fig. 2 Endoscopic finding showing a phytobezoar stuck in the lumen of the duodenum.

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  Fig. 3 Endoscopic findings. (A) The bezoar was pulled out into the gastric cavity using a snare. (B) The bezoar was fragmented into small pieces using lithotripsy. (C) Residual ulcers in the duodenum. (D) The removed bezoar.

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  Fig. 4 Follow-up endoscopic findings obtained 3 months after removal.

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