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A 43-year-old woman presented with 1 day of epigastric pain and a developing fever. She was tachycardic and febrile. Physical examination showed rebound tenderness on the left upper quadrant with decreased bowel sounds. CT of the abdomen revealed duodenal perforation surrounding a mass of unknown nature (figure 1). An oesophagogastroduodenoscopy showed a phytobezoar unusually located in the fourth duodenal segment (figure 2). A bezoar is a rare cause of small bowel perforation that most frequently occurs in …
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Contributors BM: resident who wrote the manuscript and participated in the care of the patient—analysis and interpretation of the data—drafting of the article—final approval of the article C-WL: attending physician who participated in the care of the patient—critical revision of the article for important intellectual content—final approval of the article K-HC: attending physician who participated in the care of the patient—critical revision of the article for important intellectual content—final approval of the article J-HC: corresponding author, attending physician who performed the surgery and made the clinical decisions for the care of the patient—conception and design—analysis and interpretation of the data—critical revision of the article for important intellectual content—final approval of the article.
Funding This work was supported by the Taipei Tzu Chi hospital (TCRD-TPE-108-63).
Competing interests None declared.
Provenance and peer review Not commissioned; internally peer reviewed.