Intestinal obstruction due to bezoars.

A patient with acute intestinal obstruction due to unrecognized gastric phytobezoars is presented. There was no history of prior gastric or other abdominal surgery. At laparotomy several fragments of rubbery material were discovered obstructing the ileocecal valve. Exploration of the upper gastrointestinal tract revealed two partially fragmented bezoars in the stomach which were removed through a gastrotomy. After surgery the patient recounted the ingestion of persimmons a few weeks before the onset of her symptoms. A review of the literature reveals bezoars to be an infrequent, although not an altogether rare, cause of small bowel obstruction in patients without antecedent gastric surgery. A careful dietary history should accompany all patients presenting with acute intestinal obstruction.