Iwamuro Masaya, Urata Haruo, Hirata Shoichiro, Ueki Toru, Hanabata Tetsuro, Takeda Sho, Teraoka Akira, Okada Hiroyuki
Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama 700-8558, Japan.
Department of Internal Medicine, Teraoka Memorial Hospital, Fukuyama 729-3103, Japan.
Case Rep Gastrointest Med. 2019 May 23;2019:5742672. doi: 10.1155/2019/5742672. eCollection 2019.
A 68-year-old Japanese man was diagnosed with bezoar in the stomach, which was endoscopically retrieved. The bezoar was composed of bilirubin calcium, calcium carbonate, and fatty acid calcium. Due to the presence of bilirubin calcium in the bezoar, we performed imaging studies of the bile duct; gallstones and common bile duct stones were identified. Although bezoar with components similar to bile is infrequently encountered, our findings suggest that a bezoar originating from bile should be considered among the differential diagnoses in patients without a recent consumption history of persimmons who demonstrate a mass in the digestive tract. This case highlights the importance of component analysis of gastric bezoars because its findings may alter the treatment plan.
一名68岁的日本男性被诊断出胃内有胃石，通过内镜取出。该胃石由胆红素钙、碳酸钙和脂肪酸钙组成。由于胃石中存在胆红素钙，我们对胆管进行了影像学检查；发现了胆结石和胆总管结石。尽管含有与胆汁成分相似的胃石很少见，但我们的研究结果表明，对于近期没有食用柿子史且消化道有肿物的患者，在鉴别诊断时应考虑源自胆汁的胃石。该病例强调了胃石成分分析的重要性，因为其结果可能会改变治疗方案。
