A Case of Small Bowel Obstruction due to Bezoar in a Patient with Diabetes

Tomoaki Shinohara, Kijuro Takanishi, Jusei Yuri and Tomohito Minami

Department of Surgery, Tokyo Metropolitan Fuchu Hospital

A 62-year-old woman with diabetes mellitus referred for nausea and vomiting evidenced intestinal obstruction after admission. We palpated a moving mass from her abdominal wall, and ultrasonography revealed an intraluminal echogenic mass lesion with an intense acoustic shadow. A mottled gas pattern in this mass was seen in computed tomography. We preoperatively diagnosed small bowel obstruction due to bezoar. The bezoar was impacted at the jejunum 120 cm from the Treitz ligament, and extracted by enterotomy. We diagnosed persimmon bezoar consisted of tannin, and speculated an influence of diabetes mellitus as its pathogenesis.

Key words
bezoar, small bowel obstruction, diabetes mellitus

Reprint requests
Tomoaki Shinohara Department of Gastroenterological Surgery, Tokyo Woman's Medical University 8-1 Kawada-cho, Shinjyuku-ku, Tokyo, 162-8666 JAPAN

Accepted
September 25, 2002

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