A Rare Case of Gastric Phytobezoar (Diospyrobezoar) in a Healthy Adult.

Phytobezoars are solid masses of indigestible plant material and are a common type of gastrointestinal bezoar, with varying incidences globally. These bezoars typically form from the ingestion of high-fiber fruits and vegetables and are associated with factors such as decreased gastric acid production and delayed gastric emptying. We present a case of a 35-year-old healthy man with recurrent upper abdominal pain, nausea, a rolling ball sensation in the abdominal region, and a history of consuming unripe persimmons. Imaging revealed the presence of phytobezoars in the stomach, leading to unsuccessful endoscopic attempts at removal. Laparoscopic extraction was eventually performed successfully after failed conservative management. The case highlights the rarity of diospyrobezoars, a subtype of phytobezoars formed from persimmon ingestion, and the challenges in their management. Surgical intervention, particularly laparoscopic extraction, can be effective but carries risks such as surgical site infections. Comprehensive care involving diagnostic imaging, non-surgical interventions, and surgical techniques is crucial for the successful management of phytobezoars. Phytobezoars, though relatively common, present unique diagnostic and management challenges, especially when formed from specific dietary factors such as persimmons. Understanding their epidemiology, clinical manifestations, and treatment options, including the role of laparoscopic surgery, is essential for optimizing patient outcomes and minimizing complications such as surgical site infections.

Gut microbiota analyses of inflammatory bowel diseases from a representative Saudi population.

BACKGROUND: Crohn's diseases and ulcerative colitis, both of which are chronic immune-mediated disorders of the gastrointestinal tract are major contributors to the overarching Inflammatory bowel diseases. It has become increasingly evident that the pathological processes of IBDs results from interactions between genetic and environmental factors, which can skew immune responses against normal intestinal flora. METHODS: The aim of this study is to assess and analyze the taxa diversity and relative abundances in CD and UC in the Saudi population. We utilized a sequencing strategy that targets all variable regions in the 16 S rRNA gene using the Swift Amplicon 16 S rRNA Panel on Illumina NovaSeq 6000. RESULTS: The composition of stool 16 S rRNA was analyzed from 219 patients with inflammatory bowel disease and from 124 healthy controls. We quantified the abundance of microbial communities to examine any significant differences between subpopulations of samples. At the genus level, two genera in particular, Veillonella and Lachnoclostridium showed significant association with CD versus controls. There were significant differences between subjects with CD versus UC, with the top differential genera spanning Akkermansia, Harryflintia, Maegamonas and Phascolarctobacterium. Furthermore, statistically significant taxa diversity in microbiome composition was observed within the UC and CD groups. CONCLUSIONS: In conclusion we have shown that there are significant differences in gut microbiota between UC, CD and controls in a Saudi Arabian inflammatory bowel disease cohort. This reinforces the need for further studies in large populations that are ethnically and geographically diverse. In addition, our results show the potential to develop classifiers that may have add additional richness of context to clinical diagnosis of UC and CD with larger inflammatory bowel disease cohorts.

Acute Pancreatitis as a Complication of Intragastric Balloon.

The intragastric balloon is a common minimally invasive procedure used prior to bariatric surgery for weight reduction. There are complications of this balloon with varying degrees of severity ranging from mild to severe life-threatening complications. Acute pancreatitis due to direct compression or catheter migration of the balloon should be considered in these patients. In the literature, there is little evidence that intragastric balloons could cause acute pancreatitis. We present two cases in which they had a history of IGB insertion complicated by acute pancreatitis. The diagnosis of acute pancreatitis due to the intragastric balloon was made after excluding other possible causes of acute pancreatitis. Both patients were hospitalized and managed conservatively.