Giant gastric lithobezoar in an adult: A case report

Introduction: A bezoar is a conglomeration of partially digested or undigestible foreign material in the gastrointestinal tract, classified according to its composition. Inorganic matter bezoars are very rare, especially lithobezoars, i.e., stone-composed, in the upper digestive system. Case Report: A case of 49-year-old male, schizophrenic patient, with a prior history of pica presenting with non-specific symptoms and a 10-kg weight loss. Upon physical examination, an enormous palpable left mass was noted and when mobilized, it produced a peculiar sound. Diagnostic workup comprised exclusively plain radiographs, with pathognomonic findings and subsequent indication of surgery. Exploratory laparotomy revealed a 3.5-kg gastric bezoar encompassing diverse objects, but predominantly stones. There was no evidence of their presence in other organs and no complications. The patient had uneventful recovery and is currently engaged in outpatient follow-up. Conclusion: Pica with resulting bezoar should be suspected in psychiatric adult patients with non-specific symptoms. Giant upper gastrointestinal lithobezoars are very rare and may produce a gastric ＂crunch sign＂ on physical examination, which is a clue for the correct diagnosis. Open surgery is effective and can be the treatment of choice.

並列關鍵字

Bezoar ； Crunch sign ； Gastric ； Lithobezoar ； Mass ； Pica

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