title: An Unusual Cause of Duodenal Obstruction: Persimmon Phytobezoar.
abstract: Duodenal phytobezoar, an unusual cause of acute duodenal obstruction, is rarely seen. The most common cause of this type of bezoar is persimmon. It frequently arises from underlying gastrointestinal tract pathologies (gastric surgery, etc.). Here, we report the case of a 66-year-old man who had undergone distal gastrectomy with Billroth I reconstruction for gastric cancer and experienced severe epigastric discomfort, abdominal pain, and vomiting for a few days. The abdominal computed tomography scan showed a large-sized mass in the horizontal portion of the duodenum. On following endoscopic examination, a large phytobezoar was revealed in the duodenum. He was treated with endoscopic fragmentation combined with nasogastric Coca-Cola. The patient tolerated the procedure well and resumed a normal oral diet 3 days later.
authors.affiliation: Department of Surgery, Jinling Hospital, Nanjing University School of Medicine, 305 East Zhongshan Road, Nanjing, 210002 China.
authors.forename: Shengxian
authors.initials: S
authors.lastname: Fan
authors.affiliation: Department of Surgery, Jinling Hospital, Nanjing University School of Medicine, 305 East Zhongshan Road, Nanjing, 210002 China.
authors.forename: Jing
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Surgery, Jinling Hospital, Nanjing University School of Medicine, 305 East Zhongshan Road, Nanjing, 210002 China.
authors.forename: Yousheng
authors.initials: Y
authors.lastname: Li
keywords: Coca-Cola; Duodenal obstruction; Endoscopic fragmentation; Persimmon phytobezoar