Case Report
A 65-year-old woman presented to our hospital with a complaint of abdominal pain. Abdominal computed tomography (CT) revealed multilayer arc-like high-density objects in the stomach (Figure A, yellow arrows). The patient had eaten several pieces of 30-mm mochi in a Japanese traditional soup dish without enough chewing. Mochi is made of short-grain japonica glutinous rice that becomes extremely sticky after boiling or toasting. It is an indispensable food in Japan, especially in the New Year’s holiday but has caused numerous deaths by suffocation among elderly people every year because of its stickiness. In the present case, emergency endoscopy revealed 10 completely intact round mochi (Figure B), which remained intact after 5 days. The stomach temperature stiffens mochi to an extent indissoluble by gastric juice. We endoscopically sliced the mochi to <10 mm by snaring without electrical current (Figure C). Digestive enzyme (Excelase 3.0 g/day, Meiji Seika Pharma Holdings Co, Ltd) was prescribed. Two days after snare cutting, endoscopy revealed that all the mochi had disappeared, and abdominal CT revealed no residual mochi in the intestine. Ten-millimeter mochi can be drained to the duodenum from the pylorus ring, where it can then be dissolved by bile and pancreatic juice [1].