A 76-year-old woman was hospitalized because of abdominal pain for 10 hours. Physical examination showed epigastric tenderness without rebound pain. No palpable mass was found. An initial laboratory finding revealed an elevated serum amylase level of 745 IU/L (normal range, 35 to 135 IU/L) and elevated C-reactive protein of 112 mg/L (normal range, 0–12 mg/L). The hemoglobin level was 11.0 g/dL (normal range: 13–17.5 g/dL). CA19−9 was 55 IU/ mL (reference range, 0−40 IU/mL). Aspartate aminotransferase and alanine aminotransferase were normal. Alkaline phosphatase was 197 IU/L (normal range: 50–130 IU/L), and gamma-glutamyl transpeptidase was 135 IU/L (normal range: 10–60 IU/L). Acute pancreatitis was initially diagnosed. However, computed tomography of the abdomen showed a well-defined, ovoid-shaped, intraluminal mass in the descending segment of duodenum causing high grade dilation of common bile duct (Fig. 1A, B), characterized by a solid outer rim and a heterogeneous central portion, which was well-defined by magnetic resonance imaging and upper gastrointestinal barium radiograph (Fig. 1C, D). Ultrasound guided percutaneous transhepatic biliary drainage was reserved just in case of the aggravated obstructive jaundice. Endoscopy showed one huge phytobezoar near the duodenal papilla (Fig. 2A). Further questioning of the patient found that she had eaten dried persimmons. Endoscopic fragmentation with biopsy forceps was failed due to the hard consistency. She ingested Coca-Cola but developed vomiting and duodenal obstruction. An exploratory laparotomy was subsequently performed on the patient. An elastic intraluminal phytobezoar, measured 5 × 3 × 3 cm, obstructed the duodenum. Histopathology confirmed the phytobezoar (Fig. 2B).