Abstract
Three patients with gastric bezoars coexisting with diabetes mellitus were analyzed in terms of their associated clinical features and the pathological characteristics of their bezoars. It is known that gastric bezoars are occasionally found in diabetics, but the incidence of this disease is rare and few cases are reported in the literature.
The first case was a 49-year-old man who was admitted to the hospital in severe metabolic alkalosis caused by upper gastrointestinal ileus. The endoscopic examination of the upper gastrointestinal system revealed a bezoar incarcerated in the duodenal bulb. The second case was a 54-year-old woman. A very large hemorrhagic gastric ulcer was demonstrated associated with a bezoar. These cases were considered to be non-persimmon phytobezoars associated with severe diabetic autonomic neuropathy. The third case was a 49-year-old man, who came to the hospital because of vomiting and precordial pain. The gastric endoscopy showed an ulcer and a bezoar in the stomach. He had eaten many persimmons a few months previously. The bezoar appeared to be a persimmon phytobezoar. Thus, although the three cases had a similar diabetic background, the clinical features and histpathological characteristics of their bezoars were different, indicating that the pathophysiology of bezoars accompanied by diabetes mellitus is complex and remains to be studied.
