Journal of Education and Teaching in Emergency Medicine

A 14-year-old female patient presented to the pediatric emergency department (ED) with chief complaints of abdominal pain, vomiting, and unintentional weight loss. A palpable abdominal mass was noted on exam, prompting a computed tomography (CT) scan which revealed a gastric bezoar that had fragmented, leading to intermittent and spontaneously resolving small bowel obstruction. The patient underwent surgical removal of the bezoar for definitive management.

This report highlights a novel case of spontaneous bezoar fragmentation and its associated imaging findings. Because this phenomenon represents the description of a rare occurrence, the goal is to enhance the emergency medicine providers’ understanding of an uncommon cause of abdominal masses and small bowel obstruction (SBO).