Endoscopic removal of gastric persimmon bezoar-a case report

Abstract

A 80-year-old man visited our hospital complaining of epigastric pain and vomiting lasting for a week. The upper gastrointestinal endoscopy revealed a gold bezoar about 5 cm in diameter at the greater curvature of the upper body of the stomach associated with multiple ulcers (H₁ stage) on the lesser curvature of the antrum. We attempted to remove the bezoar endoscopically using a retrieval net (Model 0071182 USE Group, Olympus Ltd. Tokyo) with success. The bezoar was 5×4×3 cm in size and 7.72g in weight. Compornent analysis with infrared absorption spectrum of the sample detected tannic acid, giving a diagnosis of persimmon bezoar.
As gastric bezoar has been reported to be a cause of ulcer due to mechanical stimulation or intestinal obstruction, removal of bezoar should be considered on diagnosis regardless of symptoms. Endoscopic approach using a retrieval net is a safe and effective modality.