- 作者：Ahmet Pergel ; pergelahmet@hotmail.com ; Ahmet Fikret Yucel ; Ibrahim Aydin ; Dursun Ali Sahin
- 关键词：Duodenal diverticul ; Phytobezoar ; Persimmon ; Laparoscopic treatment
- 刊名：International Journal of Surgery Case Reports
- 出版年：2012
- 期刊代码：pca193_22102612
- 类别：med
- 出版时间：2012
- 卷：3
- 期：8
- 页码：392-394
- 文件大小：643 K
INTRODUCTION
Primer small intestine bezoar is seen rarely. It frequently arises from underlying small intestine pathologies (diverticle, tumor, stricture etc.). We report a very rare case of disopyrobezoar in the duodenal diverticulum, a kind of phytobezoar caused by persimmons, which was treated laparoscopically.PRESENTATION OF CASE
The 47-year-old patient applied to polyclinic with complaints of epigastric tenderness, occasional distension, and acid regurgitation. In endoscopical examination, impacted bezoar was determined in the diverticulum in the duodenum. Because it is too hard, it was unable to remove endoscopically. On the abdominal tomography, a smooth-bounded non-homogeneous mass including gas and soft tissue areas in the 2nd portion of the duodenum was detected. A barium meal confirmed the presence of a 5 cm diameter diverticulum on the lateral wall of the second portion of the duodenum. It also showed an intraluminalfilling defect as well as the mottled appearance of the bezoar. Learned from history of the patient, that the patient consumed over persimmon in childhood.
DISCUSSION
Generally, duodenal diverticles are asymptomatic. Surgical treatment is rarely necessary because of complications such as bleeding, perforation, abdominal pain, bezoar formation. As well as using methods such as gastric lavage, enzymatic dissolution, endoscopical fragmentation in the treatment of phytobezoar, their chances of success are low because its structure is rigid. Usually, surgical intervention is required.
CONCLUSION
For the treatments of bezoar cases located in the small intestine, laparoscopic surgical method is a safe and feasible method in selected cases.