Phytobezoar: A Brief Report with Surgical and Radiological Correlation

Case Reports in Surgery
Sameer A HirjiJonathan D Gates

Abstract

Gastrointestinal bezoars, collections of incompletely digested material within the alimentary tract, can present as a diagnostic challenge and should be considered in the differential diagnosis and management of small bowel obstruction, ischemic bowel, or bowel perforation. We present a case of a 37-year-old man with a distant history of laparotomy for superior mesenteric artery thrombosis requiring partial small bowel resection of the jejunum who presented with worsening abdominal pain, nausea, vomiting, and hematemesis. An abdominal computed tomography revealed dilated loops of small bowel with a transition point at the ileum, distal to his prior bowel anastomosis. He was managed initially nonoperatively, but persistent vomiting and worsening distention necessitated urgent exploratory laparotomy. During the procedure, a 4 cm by 3 cm phytobezoar was discovered at the midjejunum. The patient had an unremarkable postoperative course with no further symptoms at 1-year follow-up. Timely diagnosis and treatment of bezoar is essential to minimize patient complications.

References

Mar 13, 2012·World Journal of Gastroenterology : WJG·Metin KementSelahattin Vural
Dec 21, 2012·Alimentary Pharmacology & Therapeutics·S D LadasI Zouboulis-Vafiadis
Jun 15, 2014·BMJ Case Reports·Om Prakash DhakalDhurba Bhandari
Apr 23, 2015·World Journal of Gastrointestinal Endoscopy·Masaya IwamuroKazuhide Yamamoto
Dec 30, 2016·Oxford Medical Case Reports·Nasrin RazavianzadehMohammad Forozeshfard

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