Case Reports
Vol. 21 No. 4 (2025)
Shiitake mushroom bezoar: a rare cause of small bowel obstruction in Vietnam and lessons in diagnosis and management
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Received: 24 February 2025
Accepted: 17 June 2025
Accepted: 17 June 2025
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Small Bowel Obstruction (SBO) caused by shiitake mushroom bezoars is a rare clinical entity, with no prior cases documented in Vietnam despite the frequent consumption of these mushrooms in traditional dishes. We report the case of a 69-year-old male who presented with SBO symptoms after ingesting a whole shiitake mushroom without chewing due to significant molar tooth loss. Computed Tomography (CT) imaging revealed characteristic features of a bezoar, and exploratory laparoscopy confirmed an obstructing shiitake mushroom bezoar, which was removed via enterotomy. This case highlights the diagnostic challenges of radiolucent bezoars and the critical importance of dietary history and characteristic CT findings. Preoperative assessments could facilitate less invasive surgical strategies, reducing the risks associated with enterotomy, such as anastomotic leakage. Clinicians should remain aware of regional dietary practices to enhance diagnostic precision and optimize management strategies, especially in highrisk populations with compromised mastication.
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Ten Broek RPG, Krielen P, Di Saverio S, et al. Bologna guidelines for diagnosis and management of adhesive small bowel obstruction (ASBO): 2017 update of the evidence-based guidelines from the world society of emergency surgery ASBO working group. World J Emerg Surg 2018;13:24. DOI: https://doi.org/10.1186/s13017-018-0185-2
Amara Y, Leppaniemi A, Catena F, et al. Diagnosis and management of small bowel obstruction in virgin abdomen: a WSES position paper. World J Emerg Surg 2021;16:36. DOI: https://doi.org/10.1186/s13017-021-00379-8
Ng GH, Teoh LY, Teh MS, et al. A case series of intestinal obstruction secondary to shiitake mushroom intake during Chinese New Year. J Surg Case Rep 2020;2020:rjaa328. DOI: https://doi.org/10.1093/jscr/rjaa328
Soga K, Mukai H, Kitae H. Management of shiitake mushroom-induced ileus using balloon enteroscopy. Dig Endosc 2022;34:e58-e9. DOI: https://doi.org/10.1111/den.14243
Ho MP, Chou AH, Cheung WK. Small bowel obstruction secondary to a mushroom bezoar. J Am Geriatr Soc 2013;61:1041-3. DOI: https://doi.org/10.1111/jgs.12285
Yakan S, Sirinocak A, Telciler KE, et al. A rare cause of acute abdomen: small bowel obstruction due to phytobezoar. Ulus Travma Acil Cerrahi Derg 2010;16:459-63.
Chi-Chi C, Ching-Ching C, Hsiang-Chun J, et al. Small Bowel obstruction caused by bezoar: a case series. Ame J Surg Clin Case Rep 2024;8:1-7
Baharudin MS, Syazwani AR, Mahamad S, Anita B. Mushroom bezoar: rare cause of small bowel obstruction, a case report and literature review. Asian J Case Rep Surg 2021;4:792-5.
Hitosugi M, Kitamura O, Takatsu A, Yoshino Y. Autopsy case of duodenal obstruction from impacted mushroom. J Gastroenterol 1998;33:562-5. DOI: https://doi.org/10.1007/s005350050133
Tan J, Yuan K, Zuo J, et al. Two cases of small bowel obstruction due to a shiitake mushroom. Gastroenterol Rep (Oxf) 2019;7:298-300. DOI: https://doi.org/10.1093/gastro/gox028
Hayes PG, Rotstein OD. Gastrointestinal phytobezoars: presentation and management. Can J Surg 1986;29:419-20.
Iwamuro M, Okada H, Matsueda K, et al. Review of the diagnosis and management of gastrointestinal bezoars. World J Gastrointest Endosc 2015;7:336-45. DOI: https://doi.org/10.4253/wjge.v7.i4.336
Mihai C, Mihai B, Drug V, Cijevschi Prelipcean C. Gastric bezoars--diagnostic and therapeutic challenges. J Gastrointestin Liver Dis 2013;224:111.
Kirshtein B, Roy-Shapira A, Lantsberg L, et al. Laparoscopic management of acute small bowel obstruction. Surg Endosc 2005;19:464-7. DOI: https://doi.org/10.1007/s00464-004-9038-z
Hemmasi G, Zanganeh E, Hosseini SA, et al. Risk factors, endoscopic findings, and treatments in upper gastrointestinal bezoars: multi-center experience in Iran. Gastroenterol Hepatol Bed Bench 2021;14:160-4.
Zissin R, Osadchy A, Gutman V, et al. CT findings in patients with small bowel obstruction due to phytobezoar. Emerg Radiol 2004;10:197-200. DOI: https://doi.org/10.1007/s10140-003-0297-0
Burkill GJ, Bell JR, Healy JC. The utility of computed tomography in acute small bowel obstruction. Clin Radiol 2001;56:350-9. DOI: https://doi.org/10.1053/crad.2000.0655
Wang PY, Wang X, Zhang L, et al. Bezoar-induced small bowel obstruction: Clinical characteristics and diagnostic value of multi-slice spiral computed tomography. World J Gastroenterol 2015;21:9774-84. DOI: https://doi.org/10.3748/wjg.v21.i33.9774
Moriwaki Y, Otani J, Okuda J. Small Bowel obstruction with a mass due to an impacted shiitake mushroom: specific ct images. Am Surg 2019;85:e290-1. DOI: https://doi.org/10.1177/000313481908500607
Kusumoto M, Koganemaru M, Nakayama G, Iwamoto R. Dietary small bowel obstruction. BMJ Case Rep 2013;2013:bcr2012007950. DOI: https://doi.org/10.1136/bcr-2012-007950
Miyagishima D, Inoue M, Kinjo K, et al. Bowel obstruction due to shiitake mushrooms: diagnostic features on computed tomography. Intern Med 2022;61:3349-54. DOI: https://doi.org/10.2169/internalmedicine.9181-21
Paschos KA, Chatzigeorgiadis A. Pathophysiological and clinical aspects of the diagnosis and treatment of bezoars. Ann Gastroenterol 2019;32:224-32 DOI: https://doi.org/10.20524/aog.2019.0370
Shozushima M, Ohata K, Nonaka K, Matsuhashi N. Shiitake mushroom-induced ileus managed using double-balloon enteroscopy. Endoscopy 2013;45:E437. DOI: https://doi.org/10.1055/s-0033-1359138
Park SE, Ahn JY, Jung HY, et al. Clinical outcomes associated with treatment modalities for gastrointestinal bezoars. Gut Liver 2014;8:400-7. DOI: https://doi.org/10.5009/gnl.2014.8.4.400
How to Cite
Shiitake mushroom bezoar: a rare cause of small bowel obstruction in Vietnam and lessons in diagnosis and management. (2025). Emergency Care Journal, 21(4). https://doi.org/10.4081/ecj.2025.13766
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