我們報告一個病例為年老男性，以腹痛表現而診斷為糞石造成的小腸阻塞，並回顧文獻。病人一開始的表現為上腹痛及噁心嘔吐等症狀。腹部的放射線攝影顯示瀰漫性小腸擴張。腹部超音波及電腦斷層掃描皆看到小腸腔內腫塊及小腸擴張。病人在保守治療失敗後，進行剖腹手術。手術中，糞石成功的被捏碎並順勢擠往盲腸。手術後病人恢復良好並順利出院。因此這個病例告訴我們如果保守治療失敗後，剖腹手術也可以利用腹腔鏡成功的治療，不一定要將小腸切開。且早期辨認出典型症狀和影像對減少疾病死亡率有很重要的角色。

We report the case of an elderly male who was presented with abdomen pain and diagnosed of small bowel obstruction caused by bezoar and review the literature. The initial presentation was epigastralgia with nausea and vomiting. Plain abdomen film showed diffuse dilated bowel loop. Both abdomen ultrasound and computed tomography all showed an intraluminal mass with bowel dilatation. Due to failure of conservative treatment, laparotomy was performed. Bezoar was fragmented and milked into cecum. The patient was recovered smoothly and discharged from our hospital. Therefore, it is a reminder that if conservative treatment of small bowel obstruction is failure, surgical intervention can be performed smoothly by laparoscopy without enterotomy. Early recognition with typical symptom and image findings play an important role in minimizing the morbidity and mortality.