Duodenal obstruction following acute pancreatitis caused by a large duodenal diverticular bezoar.
Bezoars are concretions of indigestible materials in the gastrointestinal tract. It generally develops in patients with previous gastric surgery or patients with delayed gastric emptying. Cases of periampullary duodenal divericular bezoar are rare. Clinical manifestations by a bezoar vary from no symptom to acute abdominal syndrome depending on the location of the bezoar. Biliary obstruction or acute pancreatitis caused by a bezoar has been rarely reported. Small bowel obstruction by a bezoar is also rare, but it is a complication that requires surgery. This is a case of acute pancreatitis and subsequent duodenal obstruction caused by a large duodenal bezoar migrating from a periampullary diverticulum to the duodenal lumen, which mimicked pancreatic abscess or microperforation on abdominal computerized tomography. The patient underwent surgical removal of the bezoar and recovered completely.
Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul 137-701, South Korea.
Ji Hun
JH
Kim
Jae Hyuck
JH
Chang
Sung Min
SM
Nam
Mi Jeong
MJ
Lee
Il Ho
IH
Maeng
Jin Young
JY
Park
Yun Sun
YS
Im
Tae Ho
TH
Kim
Il Young
IY
Park
Sok Won
SW
Han
D000208:Acute Disease; D000368:Aged; D001630:Bezoars / Q000150:complications / Q000175:diagnosis*; D004240:Diverticulum / Q000150:complications / Q000175:diagnosis*; D004380:Duodenal Obstruction / Q000209:etiology*; D005260:Female; D005548:Foreign-Body Migration / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D010195:Pancreatitis / Q000209:etiology*