ArticleSurgical case reports2026
Single-Incision Laparoscopic-Assisted Segmental Small-Bowel Resection for Small-Bowel Obstruction Caused by a Persimmon Bezoar: A Case Report.
Article in Surgical case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionSmall-bowel obstruction (SBO) caused by a bezoar is uncommon. We report a case of SBO due to a persimmon phytobezoar (diospyrobezoar) in a patient with a history of distal gastrectomy, treated by single-incision laparoscopic-assisted surgery (SILS) with segmental small-bowel resection. CASE PRESENTATION: An 83-year-old woman with a history of distal gastrectomy (Billroth I reconstruction) and habitual consumption of dried persimmons presented with abdominal pain and vomiting. Initial non-contrast CT showed small-bowel dilatation without a definitive intraluminal mass. A subsequent ileus-tube contrast study demonstrated a 50-mm oval filling defect with complete obstruction. Ultrasonography revealed an intraluminal mass with heterogeneous echoes and posterior acoustic shadowing, and repeat non-contrast CT identified a gas-containing intraluminal mass consistent with a bezoar. After adequate decompression via an ileus tube, SILS was performed on day 6 of admission. Intraoperatively, the bezoar was firmly impacted and immobile; therefore, segmental small-bowel resection with functional end-to-end anastomosis was performed. Histopathology showed submucosal edema, congestion, hemorrhage, and inflammatory cell infiltration, indicating pressure-related circulatory impairment.
conclusionsFirmly impacted persimmon bezoars may cause microscopic bowel-wall injury even without macroscopic necrosis. Segmental small-bowel resection can be a reasonable surgical option when bezoar impaction is severe and prolonged. SILS is a feasible minimally invasive approach in selected cases following adequate decompression.
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