title: Diospyrobezoar as a cause of small bowel obstruction.
abstract: Phytobezoar, a concretion of indigestible fibers derived from ingested vegetables and fruits, is the most common type of bezoar. Diospyrobezoar is a subtype of phytobezoar formed after excessive intake of persimmons (Diospyros kaki). We report the case of a diabetic man with a 5-day history of abdominal pain after massive ingestion of persimmons who developed signs of complicated small bowel obstruction. The patient had a previous history of Billroth II hemigastrectomy associated with truncal vagotomy to treat a chronic duodenal ulcer 14 years earlier. Since intestinal obstruction was suspected, he underwent emergency laparotomy that revealed an ileal obstruction with small bowel perforation and local peritonitis due to a phytobezoar that was impacted 15 cm above the ileocecal valve. After segmental intestinal resection, the patient had a good recovery and was discharged on the 6th postoperative day. This report provides evidence that diospyrobezoar should be considered as a possible cause of small bowel obstruction in patients who have previously undergone gastric surgery.
authors.affiliation: São Francisco University Medical School.
authors.forename: Andréia Padilha
authors.initials: AP
authors.lastname: de Toledo
authors.forename: Fernanda Hurtado
authors.initials: FH
authors.lastname: Rodrigues
authors.forename: Murilo Rocha
authors.initials: MR
authors.lastname: Rodrigues
authors.forename: Daniela Tiemi
authors.initials: DT
authors.lastname: Sato
authors.forename: Ronaldo
authors.initials: R
authors.lastname: Nonose
authors.forename: Enzo Fabrício
authors.initials: EF
authors.lastname: Nascimento
authors.forename: Carlos Augusto Real
authors.initials: CA
authors.lastname: Martinez