We have experienced 40 cases of bezoars for the past four and a half years from October 1969 to May 1974 at the Presbyterian Medical Canter in Taegu, Korea.
In Young Nam province, there are many persimmons produced in Autumn and most of the people eat both the ordinary and primitive persimmons throughout the year. Those who eat the raw persimmons and primitive persimmons with their seeds and skins are likely to form diospyrobezoar in their; alimentary tracts.
A substance, shibuol is responsible for the pungent and astringent tastes in the raw fruit, and the shibuol forms a glue-like coagulum when it comes in contact with a hydrochloric acid in the stomach. The coagulum causes the pieced of the skins and seeds to form bolus which often becomes sufficiently large so as to produce obstruction, mechanical irritation, ulceration and perforation of the gastrointestinal tracts.
The authors have also analyzed the 40 cases statistically and reviewed the pathogenesis, clin-ical symptoms, signs, laboratory data, treatment and complications.
1) During 3 months between November to January, bezoars s were most frequently found among the patients being admitted to this hospital.
2) The bezoars were also most frequently seen in preschool and primary school age groups.
3) Male was predominant in incidence, especially the rural population were more frequently afflicted than urban ones.
4) Most of the clinical symptoms and signs were derived from intestinal obstructions and mechanical irritation of the gastrointestinal mucosa by the bezoars.
5) Most frequent location of the bezoar was in the ileum which is narrowest portion of the small bowel and. next most frequent location was the stomach where the coexisting gastric ulcers were found in several cases.
6) Of those 40 cases who were admitted. 39 patients were treated surgically and one patient spontaneously passed the bezoar per rectum.
7) Incidence of postoperative wound infection was unusually high and revealed to be 28%. The cause of high incidence of the wound infections was thought to be due to the overgrowth of the intestinal micro-organism in the stagnated intestinal contents of the cases of distal ileal obstruction.
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