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September 1980


Arch Surg. 1980;115(9):1137. doi:10.1001/archsurg.1980.01380090101029

To the Editor.—Bezoars containing a wide variety of ingredients have been reported frequently.1,2 The following case is of a bezoar with a most unusual cause.

Report of a Case.—A 30 year-old patient in a state mental institution had an abdominal mass and a history that included eating old discarded cigarettes. Examination disclosed a healthy-appearing, retarded man, with both hands clutching cigarette detritus, who was wearing sneakers sans shoestrings. A 15 × 20-cm, movable, nontender mass filled his left upper quadrant. Results of rectal examination were normal; stool was guaiac negative. An intravenous pyelogram was normal. Barium enema showed that the transverse colon was displaced anteriorly. An upper gastrointestinal series disclosed a large, irregular mass that filled the stomach, with strands extending into the duodenum (Figure).

With the preoperative diagnosis of a cigarette-butt gastric bezoar, a laparotomy was performed. A massive gastric bezoar was found, as well as