A rare case of a double phytobezoar causing gastric and jejunum obstruction in an adult man: a case reportReport as inadecuate




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Journal of Medical Case Reports

, 10:350

First Online: 15 December 2016Received: 08 June 2016Accepted: 08 November 2016DOI: 10.1186-s13256-016-1137-7

Cite this article as: Occhionorelli, S., Zese, M., Targa, S. et al. J Med Case Reports 2016 10: 350. doi:10.1186-s13256-016-1137-7

Abstract

BackgroundBezoars are an uncommon cause of mechanical intestinal occlusion. There are four different kinds of bezoars: phytobezoars, made of vegetables and fibers; trichobezoars, resulting from the ingestion of hair and frequently an expression of psychiatric disorders; lactobezoars, which are formed of milk curd; and pharmacobezoars, caused by drugs and medications. Symptoms are classically indistinguishable from one another and from more common causes of intestinal occlusion, so it can be difficult to establish a correct diagnosis in order to apply the correct treatment. We present a rare case of two different phytobezoars causing intestinal occlusion gastric and jejunal. We also describe the correct techniques for making a correct and fast diagnosis of occlusion caused by phytobezoars, and the possible conservative and operative treatments.

Case presentationWe present the case of a double phytobezoar that was surgically treated with a double enterotomy. Our patient was a 68-year-old Caucasian man with a medical history of hypertension, a previous open appendectomy, and open repair of a perforated gastric ulcer. He was admitted with a 5-day history of abdominal pain located in his upper quadrants along with vomiting. After a preoperative examination, he was taken to the operating room. He was discharged in a good clinical condition 11 days after surgical intervention. A physical examination at 6 months demonstrated our patient was in good health.

ConclusionsDiagnosing bezoars is difficult because of their rarity. However, they must be taken into consideration in a differential diagnosis because their treatment is not always surgical. In fact, it may be conservative in many cases and a correct diagnosis will guide towards the correct therapy.

KeywordsBezoars Phytobezoars Small bowel obstruction Gastrostomy Enterotomy AbbreviationsCTComputed tomography

SBOSmall bowel obstruction

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Author: S. Occhionorelli - M. Zese - S. Targa - L. Cappellari - R. Stano - G. Vasquez

Source: https://link.springer.com/







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