Abstract

Bezoars are mass found trapped in the gastrointestinal system and they can be diagnosed by computed tomography or endoscopic examination. Administration by dissolutions, removal by endoscopic devices, laparotomy, and laparoscopic surgery can be options for treatment. We present a case of a 60-year-old man, who had past history of right hemicolectomy of ascending colon cancer, with duodenal obstruction by a phytobezoar. During endoscopic treatment, the bezoar migrated from the duodenum to deep small intestine and made the small bowel obstruction in ileum. It didn't be dissolved by Coca-Cola. Finally, it is removed by laparoscopic enterolysis. And he was discharged without abdominal discomfort. Surgical intervention including larparotomy or larparoscopy should be undertaken for cases with ileus or refractory bezoars. However, mostly of the bezoars should be solved by the administration of dissolutions or endoscopic treatment when the bezoars are diagnosed. Small bowel obstruction secondary to migration of a bezoar during endoscopic procedure is rare and non-surgical intervention such as balloon-assisted enteroscopy could be undertaken for salvage.