A Case of Mechanical Intestinal Obstruction Due to Gastrolithiasis Caused by Ingesting a Large Amount of Mini Tomatoes

Abstract

[Case] A 22-month-old girl was referred to our center with complaints of abdominal pain and vomiting and was suspected of having strangulated bowel obstruction. The CT scan revealed no poor-contrast areas, but we detected a low-absorption object in a part of the ileum with marked dilation on its oral side. We suspected a mechanical intestinal obstruction caused by gastrolithiasis or an external foreign body and performed emergent surgery on the patient. We made a 2-cm intestinal incision right above the object, then removed the object and found fibrous components suggestive of gastrolithiasis. The patient experienced no postoperative complications. Oral intake was initiated on postoperative day 3 and the patient was discharged on postoperative day 10. Postoperative history taking revealed that the patient displayed a biased preference for large numbers of mini tomatoes. Our compositional examination revealed tannic acid-like substances consistent with gastrolithiasis. [Summary] Here, we report a case of gastrolithiasis caused by mini tomatoes. Although persimmon is a well-known cause of dietary gastrolithiasis, other types of food can also lead to the same condition. Our results should be considered in the differential diagnosis for intestinal obstruction.