A case of ileus successfully treated by colonoscopic removal of migrated gastric bezoars obstructing the terminal ileum

A 76-year-old man with abdominal pain underwent computed tomographic (CT) scan, which revealed bezoars in the stomach and ileus. The terminal ileum was obstructed by a mosaic mass with aerosol, which was suspected to be composed of bezoars that had migrated from the stomach. Because the obstruction was located in the terminal ileum, it could be reached by a colonoscope; the ileus was then released by removal of bezoars with a snare. Residual bezoars in the stomach were removed using a two-channel endoscope; the bezoars were crushed with a snare and forceps. Obstruction of the small intestine by migrated bezoars is generally an indication for surgical removal in many cases; however, by using a colonoscope to reach the location of the obstruction site and based on the appropriate imaging diagnosis, surgical removal was avoided in this case.