Duodenal obstruction following acute pancreatitis caused by a large duodenal diverticular bezoar

• Published in: World journal of gastroenterology : WJG 2012-10, Vol.18 (38), p.5485-5488
• Main Authors: Kim, Ji Hun, Chang, Jae Hyuck, Nam, Sung Min, Lee, Mi Jeong, Maeng, Il Ho, Park, Jin Young, Im, Yun Sun, Kim, Tae Ho, Park, Il Young, Han, Sok Won
• Format: Article
• Language: English
• Subjects: Acute Disease; Aged; Bezoars - complications; Bezoars - diagnosis; Case Report; Diverticulum - complications; Diverticulum - diagnosis; Duodenal Obstruction - etiology; Female; Foreign-Body Migration - complications; Foreign-Body Migration - diagnosis; Humans; Pancreatitis - etiology; 临床表现; 十二指肠; 急性胰腺炎; 手术切除; 手术治疗; 断层扫描; 牛黄; 肠梗阻
• ISSN: 1007-9327; 2219-2840
• DOI: 10.3748/wjg.v18.i38.5485

Bezoars are concretions of indigestible materials in the gastrointestinal tract. It generally develops in patients with previous gastric surgery or patients with delayed gastric emptying. Cases of periampullary duodenal divericular bezoar are rare. Clinical manifestations by a bezoar vary from no symptom to acute abdominal syndrome depending on the location of the bezoar. Biliary obstruction or acute pancreatitis caused by a bezoar has been rarely reported. Small bowel obstruction by a bezoar is also rare, but it is a complication that requires surgery. This is a case of acute pancreatitis and subsequent duodenal obstruction caused by a large duodenal bezoar migrating from a periampullary diverticulum to the duodenal lumen, which mimicked pancreatic abscess or microperforation on abdominal computerized tomography. The patient underwent surgical removal of the bezoar and recovered completely.