Management of persimmon bezoars (diospyrobezoars).

Since 1946, 20 men and one woman aged 40 to 76 years (average 57) were operated upon for complications of diospyrobezoars. Shortly after eating persimmons, 11 (52.4%) had severe abdominal cramping, anusea, vomiting, and pyrexia. Twelve of 17 (70.9%) with gastric bezoars had hematemesis or melena caused by an associated gastric ulcer, while five (29.1%) had only moderate dyspepsia. In four (19.1%), the bezoar had lodged in the ileum, causing obstruction. Enzymatic therapy is indicated in those with minor symptoms. Gastrotomy or gastrotomy with bezoar removal and wedge resection of the gastric ulcer is recommended when enzymatic therapy fails, or when there is gastric outlet obstruction or marrise hemorrhage. Emergency exploration with removal is necessary when the persimmon bezoar causes ileal obstruction.