Abstract
A 73-year-old woman presented in December 2009 with chief complaints of nausea and heartburn, not relieved by proton pump inhibitors. At our hospital she was diagnosed with ileus by CT of the abdomen and admitted. Decompression of the bowel with ileus tube insertion failed to resolve abdominal distension. Radiography of the ileus tube on hospital day 13 revealed translucency from the ileum anal to the ileus tube tip. Abdominal CT and MRI disclosed a mass with aeration in the small intestinal lumen, suggesting bowel obstruction due to impaction of the small intestine with a gastric bezoar. As the area of translucency remained unmoved in the terminal ileum region on radiography of the ileus tube, ileus due to gastric bezoar was diagnosed and laparoscopic surgery was performed on hospital day 18. The small intestine was partially resected because a white patch was noted on the small intestinal mesentery 20 cm oral to the terminal ileum. She had a favorable course and was discharged on postoperative day 14. The foreign body measuring 6.0×3.0×2.5 cm was estimated to be a persimmon gastric bezoar. Intestinal obstruction by an incarcerated gastric bezoar is relatively rare. This report describes successful laparoscopic resection of the lesion.
