• Gastric pathology
• surgical pathology

Concretions of indigestible foreign material that accumulate in the gastrointestinal tract are known as bezoars and most commonly form in the stomach. Gastric bezoars are usually formed by indigestible plant material (phytobezoars), ingested hair (trichobezoars), conglomerations of medications or medication vehicles (pharmacobezoars), or the combination of any of the above.1 Gastric bezoars are generally soft and fibrous when formed by hair or plant material, or ‘putty-like’ with evidence of medication vehicles in the case of pharmacobezoars.1 Reports of gastric bezoars formed as solid calculi are extremely rare.

A 56-year-old male presented to our hospital following an unconscious collapse preceded by dyspnoea and light-headedness on ambulation. More than a decade previously, he had undergone a truncal vagotomy and gastrojejunostomy for a bleeding chronic duodenal ulcer which had also caused pyloric stenosis. On closer questioning, he remarked that he had noticed intermittent dark stools of increasing frequency in recent weeks and a sensation of …