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

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.