A Case of Elevated Jejunum Obstruction due to a Persimmon Bezoar after Distal Gastrectomy

Abstract

A 67-year-old man, who had undergone distal gastrectomy and reconstruction via Roux-en-Y anastomosis for early gastric cancer at the age of 63, presented at our hospital with dysphoria and vomiting. He was admitted following a diagnosis of postoperative ileus. Computed tomography and contrast radiography revealed a narrowing and obstruction of the elevated jejunum. A bezoar more than 10 cm in length was identified in the elevated jejunum during laparotomy. The bezoar was removed through a jejunotomy. Analysis of the bezoar component revealed more than 98% tannin acid, and therefore, we diagnosed a persimmon bezoar as the cause of the jejunum obstruction. The postoperative course was uneventful, and the patient was discharged on the fourteenth postoperative day.