Kim JH, Chang JH, Nam SM, Lee MJ, Maeng IH, Park JY, Im YS, Kim TH, Park IY, Han SW. Duodenal obstruction following acute pancreatitis caused by a large duodenal diverticular bezoar. World J Gastroenterol 2012; 18(38): 5485-5488 [PMID: 23082068 DOI: 10.3748/wjg.v18.i38.5485]
Corresponding Author of This Article
Jae Hyuck Chang, MD, PhD, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, 327 Sosa-ro, Wonmi-gu, Bucheon-si, Gyeonggi-do 420-717, Seoul 137-701, South Korea. wwjjaang@catholic.ac.kr
Article-Type of This Article
Case Report
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World J Gastroenterol. Oct 14, 2012; 18(38): 5485-5488 Published online Oct 14, 2012. doi: 10.3748/wjg.v18.i38.5485
Duodenal obstruction following acute pancreatitis caused by a large duodenal diverticular bezoar
Ji Hun Kim, Jae Hyuck Chang, Sung Min Nam, Mi Jeong Lee, Il Ho Maeng, Jin Young Park, Yun Sun Im, Tae Ho Kim, Il Young Park, Sok Won Han
Ji Hun Kim, Jae Hyuck Chang, Sung Min Nam, Mi Jeong Lee, Il Ho Maeng, Jin Young Park, Yun Sun Im, Tae Ho Kim, Sok Won Han, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul 137-701, South Korea
Il Young Park, Department of Surgery, College of Medicine, The Catholic University of Korea, Seoul 137-701, South Korea
Author contributions: Kim JH and Chang JH made substantial contributions in reviewing the case and compiling the data; Kim JH drafted the manuscript; Park IY performed the operation; Nam SM, Lee MJ, Maeng IH, Park JY, Im YS, Kim TH, and Han SW contributed to the discussion and reviewed the manuscript.
Correspondence to: Jae Hyuck Chang, MD, PhD, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, 327 Sosa-ro, Wonmi-gu, Bucheon-si, Gyeonggi-do 420-717, Seoul 137-701, South Korea. wwjjaang@catholic.ac.kr
Telephone: +82-32-3402227 Fax: +82-32-3402255
Received: April 3, 2012 Revised: June 21, 2012 Accepted: June 28, 2012 Published online: October 14, 2012
Abstract
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.
