# Diospyrobezoar (Persimmon Bezoar)-Induced Intestinal Obstruction in an Older Patient: A Case Report

## TL;DR

An older man developed intestinal blockage from eating too many persimmons, requiring surgery despite initial treatments.

## Contribution

This case report highlights diospyrobezoar-induced intestinal obstruction in an elderly patient without typical risk factors.

## Key findings

- A 93-year-old man with no prior gastric surgery or diabetes developed intestinal obstruction from a diospyrobezoar.
- The bezoar was composed of over 98% tannin and required surgical removal after failed non-surgical treatments.
- The case emphasizes the need for early diagnosis and patient education to prevent severe complications.

## Abstract

Diospyrobezoar is a bezoar caused by excessive persimmon (Diospyros kaki) consumption, typically occurring in individuals with risk factors such as a history of gastric surgery, diabetes, or advanced age. We report the case of a 93-year-old man who presented with anorexia, nausea, and vomiting. Computed tomography revealed a bezoar-induced obstruction in the proximal jejunum. Despite initial management with Coca-Cola (The Coca-Cola Company, Atlanta, Georgia, United States) lavage and endoscopic fragmentation, surgical intervention was required because of persistent symptoms and intestinal ulceration. A 5 × 5-cm mass composed of >98% tannin was removed, confirming the presence of a diospyrobezoar. Further history assessment revealed that the patient consumed two persimmons daily. The patient recovered uneventfully after surgery and was discharged with dietary guidance. The present case highlights the importance of identifying diospyrobezoar-induced intestinal obstruction in older persimmon consumers, even in the absence of common risk factors, such as prior gastric surgery or diabetes. Early diagnosis based on imaging findings and dietary history, followed by timely surgical treatment, is essential to prevent the development of severe complications. Moreover, educating patients about the risks of excessive persimmon consumption is essential to prevent this condition.