Giant gastric disopyrobezoar: A case report

Background: Bezoars are classified according to their composition into phytobezoar,tricobezoar, lactobezoar & mixed bezoar. A disopyrobezoar is a type of phytobezoar causedby persimmons. Phytobezoar are common bezoars in gastrointestinal tract, but giantdisopyrobezoar are rarely seen clinically. In this report a case of giant disopyrobezoar instomach is described.Case report: A 26 years old man presented with complains of acute abdominal pain , nauseaand vomiting. On physical examination has positive rebound tenderness. No mass waspalpated. Laboratory exams were shown leukocytosis with neutrophilia. The patient withclinical diagnosis of acute appendicitis was transferred to the department of surgery andappendectomy was done. Pathology report was showing vermiform appendix. After surgery,the symptoms were not resolved and aggravated. On the 2nd weak after appendectomy upperGI endoscopy was done and a giant bezoar in stomach was seen. Endoscopy wasunsuccessful to extract the bezoar. Gastrotomy was performed on the patient and a giantbezoar green-orange in color (9 x 5 x4.5 cm) was removed from the gastric lumen.Psychiatric evaluation was shown no underlying psychological & emotional disturbance. Butonly he was eaten 3 Kg persimmon on an empty stomach, 4 days before the beginning ofsymptoms. According to Chinese medicine do not eat persimmons on an empty stomach.High sugar/pectin content and the woodiness of it coagulate with other bits which can causephytobezoar and may need to be removed with surgery.

Giant gastric disopyrobezoar: A case report Keywords:

Phytobezoar , Gastric disopyrobezoar , Acute abdominal pain