2024 Volume 74 Issue 2 Pages 153-157
A 68-year-old man underwent laparoscopic-assisted distal gastrectomy (Billroth-I reconstruction) for gastric cancer one and a half years previously. He visited our hospital complaining of vomiting and abdominal pain. A computed tomography (CT) scan showed an oval residue with an air bubble in the duodenum. Since he had consumed persimmon before the onset of symptoms, intestinal obstruction due to diospyrobezoar was suspected. CT scan on admission showed that the bezoar transferred into the jejunum, resulting in intestinal obstruction; therefore， an ileus tube was implanted, and cola dissolution therapy (hereafter, cola therapy) was administered for 5 days. However, the size of the bezoar remained unchanged, and the patient began to complain of abdominal pain as cola was injected; thus, surgery was performed. Under laparoscopic assistance, the jejunum was elevated outside the body cavity, and the bezoar was removed. The patient was discharged on post-operative day 14. Recently, cola therapy in patients with intestinal obstruction for diospyrobezoars has been reported; however, substantially more reports are there on patients undergoing surgery, and surgery remains the first choice for treatment. Cola therapy may cause complications, such as intestinal necrosis; therefore, it is important to always consider surgery if cola therapy is performed.
