Phytobezoar of Persimmon Origin

Abstract

In 1935, Dr. Harry C. Schmeisser, of Memphis, Tenn., reported1 two cases of phytobezoar of persimmon origin, and in his search of the literature he had found 30 authentic cases of this type, his own two cases making 32. The one reported below makes 33. Case 1. F. H., white, male, a farmer, aged 59 years, was admitted to the Veterans' Hospital for treatment of hemorrhoids. He was sent to the x-ray department for a routine gastro-intestinal examination on Nov. 9, 1935, with a history of gastro-intestinal distress. The fluoroscopic examination clearly demonstrated that there was a foreign body in the stomach. In fact, on manipulation, the observer realized that he was dealing with two foreign bodies. In the first examination, it was rather difficult to dislodge the cone-shaped body in the pyloric end of the stomach, but the larger half of the mass could be freely moved in the cardiac end. The patient was asked to return on the following morning for further investigation. On his arrival, the next day, he remarked that the manipulation had cured him, as he had had a comfortable night and felt fine. After the discovery of these foreign bodies, the observer immediately thought of the phytobezoar of persimmon origin and questioned the patient along this line. His story was a classic. History. — The patient had had chronic constipation extending back over a period of at least 20 years, but had been considerably worse during the past year. He had taken cathartics, and for the past seven months it had been necessary to take a cathartic of some kind or there would be no bowel movement at all. He had a considerable accumulation of gas in the gastro-intestinal tract at times. Occasionally, he was slightly nauseated but there had been few attacks of vomiting. He had no history of epigastric pain. There had been no vomiting of blood, nor bleeding from the intestinal tract other than from the hemorrhoids for which he was admitted to the hospital. His gastro-intestinal symptoms bore no relation to meals and were not seasonal in type. He denied that he had ever been jaundiced. The patient gave no history of any edema of the feet nor any great amount of dyspnea, although he stated that at times he had had fainting sensations, which had been ascribed to his gastro-intestinal condition. The patient was in James Walker Hospital, Wilmington, N. C., for a period of treatment for the gastro-intestinal condition mentioned above. While there, he was put on a rather scant diet consisting of milk and cereals. He was discharged from that hospital on Sept. 7, 1935, and on the following day, being still on a very scant diet, his stomach was empty and he felt very hungry. In short, while he was out in the field where some persimmon trees grew, he ate persimmon fruit—he estimated the amount to be perhaps one and one-half pints. This was about four o'clock in the afternoon. He returned to the house and ate nothing further before retiring except some soup.