Odeh Ahmed M, Alkhalifa Ahmed A, AlHajji Mohammed A, Alahmed Alwayah J, Alsalman Jawad H, AlMulhem Abdulrahman M, AlGhadeer Mohammed S, Kurdi Ezzeddin, Albader Fatima S, Alsuwaigh Abdulmohsen, Khan Mohammad A
General and Laparoscopic Surgery, Al Ahsa Health Cluster, Al Ahsa, SAU.
General Surgery, Al Ahsa Health Cluster, Al Ahsa, SAU.
Cureus. 2024 Aug 31;16(8):e68353. doi: 10.7759/cureus.68353. eCollection 2024 Aug.
Phytobezoars are solid masses of indigestible plant material and are a common type of gastrointestinal bezoar, with varying incidences globally. These bezoars typically form from the ingestion of high-fiber fruits and vegetables and are associated with factors such as decreased gastric acid production and delayed gastric emptying. We present a case of a 35-year-old healthy man with recurrent upper abdominal pain, nausea, a rolling ball sensation in the abdominal region, and a history of consuming unripe persimmons. Imaging revealed the presence of phytobezoars in the stomach, leading to unsuccessful endoscopic attempts at removal. Laparoscopic extraction was eventually performed successfully after failed conservative management. The case highlights the rarity of diospyrobezoars, a subtype of phytobezoars formed from persimmon ingestion, and the challenges in their management. Surgical intervention, particularly laparoscopic extraction, can be effective but carries risks such as surgical site infections. Comprehensive care involving diagnostic imaging, non-surgical interventions, and surgical techniques is crucial for the successful management of phytobezoars. Phytobezoars, though relatively common, present unique diagnostic and management challenges, especially when formed from specific dietary factors such as persimmons. Understanding their epidemiology, clinical manifestations, and treatment options, including the role of laparoscopic surgery, is essential for optimizing patient outcomes and minimizing complications such as surgical site infections.
植物性胃石是由难以消化的植物物质形成的固体团块,是胃肠道胃石的常见类型,在全球范围内发病率各异。这些胃石通常由摄入高纤维水果和蔬菜形成,并与胃酸分泌减少和胃排空延迟等因素有关。我们报告一例35岁健康男性病例,该患者反复出现上腹部疼痛、恶心、腹部有滚动球感,并有食用未成熟柿子的病史。影像学检查显示胃内存在植物性胃石,导致内镜下取石尝试失败。在保守治疗失败后,最终成功进行了腹腔镜取出术。该病例突出了柿石(由摄入柿子形成的植物性胃石的一种亚型)的罕见性及其治疗挑战。手术干预,尤其是腹腔镜取出术,可能有效,但存在手术部位感染等风险。对于植物性胃石的成功治疗,涉及诊断性影像学检查、非手术干预和手术技术的综合治疗至关重要。植物性胃石虽然相对常见,但存在独特的诊断和治疗挑战,尤其是由柿子等特定饮食因素形成时。了解其流行病学、临床表现和治疗选择,包括腹腔镜手术的作用,对于优化患者预后和减少手术部位感染等并发症至关重要。