Work

Bezoars-Induced Small Bowel Obstructions due to Dried Persimmons that Required Multiple Surgeries: A Case Report

Year: 2026

Type: article

Abstract: INTRODUCTION: A bezoar is an indigestible conglomeration trapped in the gastrointestinal tract. Persimmon phytobezoars, known as diospyrobezoars, are formed after the frequent consumption of persimmons and are a distinct type of phytobezoar characterized by their hard consistency. CASE PRESENTATION: A 74-year-old female presented to our hospital with persistent abdominal pain and vomiting, and an intestinal strangulating obstruction was suspected. An emergency operation was performed, and a dietary small bowel obstruction was diagnosed. A small intestinal resection, including removal of a foreign body resembling a sponge-like mass, was performed. During detailed questioning, we asked her about any history of persimmon ingestion, but she denied it. The symptoms recurred on POD 8, and another dietary small bowel obstruction was suspected after a CT examination. Conservative treatment, including Coca-Cola dissolution therapy, was performed, but the symptoms were not alleviated, and she developed a fever on POD 24. On POD 30-the 22nd day after the 2nd onset-she suddenly remembered that she had eaten 16 dried persimmons between 24 and 19 days before the onset of symptoms. A 2nd operation was performed the following day. Because feces were found in the abdominal cavity and the perforated site could not be found laparoscopically, we converted to laparotomy. At the location of the obstruction in the ileum, a foreign body and a perforation were seen, and a partial ileectomy was performed. The foreign body also resembled a sponge-like mass, and a component analysis showed that it consisted of 98% tannin. A diospyrobezoar was finally diagnosed. CONCLUSIONS: Because multiple diospyrobezoars could exist in the gastrointestinal tract, we should check for additional bezoars throughout the entire tract. Much more detailed questionnaires, including both dried and ripe persimmons, are needed. During conservative therapy, the occurrence of severe complications should be recognized.

Source: Surgical Case Reports

DOI: 10.70352/scrj.cr.26-0419

Authors: Yoshikuni Yonenaga, Ryota Ito

Institutions: AKO City Hospital, Nishiwaki Municipal Hospital

Language: English

Topic: Intestinal and Peritoneal Adhesions

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,535