Gastric coconut bezoar following Roux-en-Y gastric bypass

Abstract Coconut bezoars are rare causes of gastrointestinal obstruction, particularly in patients who have undergone Roux-en-Y gastric bypass (RYGB). Altered gastric motility and anatomical changes after bariatric surgery predispose patients to the accumulation of indigestible fibers. We report the case of a 45-year-old female who presented one year after RYGB with nausea, vomiting, and abdominal pain. Upper endoscopy revealed a coconut bezoar in the gastric pouch, which was successfully treated with endoscopic mechanical fragmentation and extraction. The patient recovered fully without surgical intervention. This case highlights the importance of considering bezoars in post-bariatric patients presenting with obstructive gastrointestinal symptoms and demonstrates the effectiveness of endoscopic management.