Gastric bezoar entering the duodenum causing intestinal obstruction: A case report

Rationale: Gastric bezoar-induced duodenal obstruction represents a rare clinical entity with <0.5% incidence among mechanical bowel obstructions. Patient concerns: A 73-year-old female patient presented to our institution, manifesting acute abdominal syndrome characterized by progressive pain and distension. Diagnoses: Computed tomography demonstrated a 3.5 cm intraluminal phytobezoar at the duodenal horizontal segment and proximal small bowel dilatation; Intraoperative: Bezoar impaction 60 cm from the ileocecal valve. Interventions: Initial conservative therapy included: fasting, anti-infection, acid suppression, indwelling gastric tube. After 72 hours of failed conservative management, laparoscopic-assisted jejunotomy was performed. Outcomes: Resolution of obstructive symptoms within 6 hours post-op and return of bowel function at 48 hours. Lessons: This diagnostically challenging case underscores the critical importance of obtaining detailed dietary histories (particularly persimmon/fig consumption) in the evaluation of mechanical bowel obstruction.