A Small Bowel Obstruction Secondary to Jejunal Bezoar

An 82-year-old woman presented with a two-day history of bilious vomiting, abdominal bloating, and epigastric discomfort. She remained hemodynamically stable without signs of peritonitis. Abdominal CT revealed small bowel obstruction with a transition point in the proximal jejunum, caused by a heterogeneous mass with curvilinear calcification, suspicious for a bezoar. Given its size, location, and the low likelihood of spontaneous passage, surgical intervention was undertaken. Laparotomy confirmed a 6×6 cm calcified bezoar located 70 cm distal to the duodenojejunal flexure, with multiple proximal jejunal and duodenal diverticula likely contributing to its formation. The bezoar was removed via enterotomy without complications. This case highlights an uncommon cause of small bowel obstruction and the importance of considering bezoars in elderly patients with underlying diverticular disease.