scholarly journals An unusual case of phytobezoar-induced small bowel obstruction

2019 ◽  
Vol 2019 (11) ◽  
Author(s):  
Yasser Taha ◽  
Khaled Salman ◽  
Fahad Alrayyes ◽  
Saad Alrayyes

Abstract Bezoars, and to lesser extent phytobezoars, are among the rare causes of small bowel obstruction. A bezoar generally describes retained concretions of indigestible foreign material that accumulate and conglomerate in the gastrointestinal tract, most commonly in the stomach. We present an unusual case of phytobezoar-induced sub-acute small bowel obstruction originating from unfamiliar plant material in a 74-year-old woman. The past history was insignificant regarding comorbidities other than depression. Presenting complaints were history of abdominal pain and vomiting. Imaging studies and physical examination suggested small bowel obstruction. The patient underwent exploratory laparotomy after 1 day of conservative treatment. We found a 4.5 cm obstructing phytobezoar intraoperatively. The undigested plant material caused the obstruction. Postoperatively, the plant was identified as Scorzonera papposa. The patient was discharged uneventfully. The elderly patients should avoid semi-cooked vegetables, plants of unknown origin and high-fibre diet.

2020 ◽  
Vol 8 (1) ◽  
pp. 354
Author(s):  
Daniel Page ◽  
Emilia Dauway

Small bowel obstructions are common acute surgical presentations often as a result of intraabdominal adhesions or herniations; rarer causes include malignancies, strictures, foreign bodies and bezoars. Phytobezoars (bezoars composed of undigested plant material) account for<4% of small bowel obstructions. Here we report an unusual case of a 56-year-old male with a virgin abdomen presenting with a small bowel obstruction, a CT scan of his abdomen and pelvis was suggestive of a closed loop small bowel obstruction. The patient progressed to have an emergency laparotomy and was found to have multiple intraluminal obstructing foreign bodies within the distal ileum. On making an enterotomy to remove and examine these, they were found to be rehydrated apple segments that the patient had ingested in the dehydrated form several hours earlier. This is an example of a phytobezoar causing bowel obstruction, contributing factors to the occurrence of these include poor gastrointestinal motility and problems of mastication; in this instance the patient had poor dentition that likely pre-disposed him to this problem.


2021 ◽  
Vol 8 (5) ◽  
pp. 83
Author(s):  
Jae-Eun Hyun ◽  
Hyun-Jung Han

A 7-month-old neutered male poodle dog presented with general deterioration and gastrointestinal symptoms after two separate operations: a jejunotomy for small-intestinal foreign body removal and an exploratory laparotomy for diagnosis and treatment of the gastrointestinal symptoms that occurred 1 month after the first surgery. The dog was diagnosed as having small-bowel obstruction (SBO) due to intra-abdominal adhesions and small-bowel fecal material (SBFM) by using abdominal radiography, ultrasonography, computed tomography, and laparotomy. We removed the obstructive adhesive lesion and SBFM through enterotomies and applied an autologous peritoneal graft to the released jejunum to prevent re-adhesion. After the surgical intervention, the dog recovered quickly and was healthy at 1 year after the surgery without gastrointestinal signs. To our knowledge, this study is the first report of a successful treatment of SBO induced by postoperative intra-abdominal adhesions and SBFM after laparotomies in a dog.


2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
P Gungadin ◽  
A Taib ◽  
M Ahmed ◽  
A Sultana

Abstract Introduction Small bowel obstruction can be caused by multiple factors. We describe an unusual case of small bowel obstruction secondary to three rare factors: gallstone ileus, peritoneal encapsulation and congenital adhesional band. Case Presentation A seventy-nine-year-old male presented with a four-day history of obstipation and abdominal pain. CT abdomen pelvis revealed small bowel obstruction secondary to gallstone ileus. The patient was managed by laparotomy. The intraoperative findings revealed the presence of a congenital peritoneal encapsulation with an adhesional band and gallstone proximal to the ileo-caecal valve. Although there was some dusky small bowel, this recovered following the release of the band. Discussion Peritoneal Encapsulation is a rare congenital pathology resulting in the formation of an accessory peritoneal membrane around the small bowel. This condition is asymptomatic and rarely presents as small bowel obstruction. The diagnosis is often made at laparotomy. There are less than 60 cases reported in literature. Gallstone ileus is another rare entity caused by an inflamed gallbladder adhering to part of the bowel resulting in a fistula. Conclusions The rarity of these conditions mean that they are poorly understood. A combination of this triad of gall stone ileus in the presence of peritoneal encapsulation and congenital band has not been reported before. Knowledge of this would raise awareness, facilitate diagnosis and management of patients.


Med Phoenix ◽  
2020 ◽  
Vol 5 (1) ◽  
pp. 26-31
Author(s):  
MD Alam Shahid ◽  
Pashupati Bhatta ◽  
Akash Raya ◽  
Binod Kumar Rai

Background: The management of adhesive small bowel obstruction is quite debatable. Gastrograffin, a water-soluble hyperosmolar contrast is used as a diagnostic tool widely but it also has impressive therapeutic role. Hence this study was to determine its therapeutic role in management of adhesive bowel obstruction after failure of conservative treatment. Methods: This cross-section observational study of 42 patients was conducted in 1-year duration from 01 July 2018 to 30 June 2019 using non-probability purposive sampling technique. All the patients were first managed conservatively for 48 hrs, and then given 100ml of gastrograffin through NG tube and clamped. Appearance of dye in cecum on radiograph at different time frame (4, 8, 12 and 24 hours of administration) signifies the success and who failed to do so within 24 hrs. were planned for laparotomy. Results: A total of 42 patients with their age ranged 14-80 years (mean 44.6) were included. Among them 32 (76.19%) were male and 10 (23.80%) female. Most had open appendectomy followed by gynaecological surgery and exploratory laprotomy. Majority had midline incision followed by gridiron and pfanensteil incision. After 8 hrs of gastrograffin administration, it was positive in 12 patients while 19 had at 24 hrs. Total 31 patients showed complete resolution, while remaining 11 showed no improvement and undergone exploratory laparotomy. Conclusion: Thus, the administration of gastrograffin is an effective approach in the management of adhesive small bowel obstruction after failed conservative management and prevents surgeries.  


Author(s):  
Thomas Worland ◽  
Ashley Bloom ◽  
Marcus Robertson

2017 ◽  
Vol 10 ◽  
pp. 117954761771924
Author(s):  
Victoria Bradford ◽  
Marissa Vadi ◽  
Harmony Carter

Foreign body ingestion is a common occurrence in the pediatric population and most ingestions resolve with little morbidity. Although radiopaque objects are easily identified on biplane radiographs, radiolucent objects may elude detection, delaying diagnosis. We report a case of a healthy 10-month-old infant who presented with a 5-day history of postprandial vomiting and imaging consistent with small bowel obstruction. On exploratory laparotomy, she was discovered to have a postpyloric foreign body requiring removal through an enterotomy.


2019 ◽  
Vol 32 (3) ◽  
pp. 240
Author(s):  
Manuela Graça Fernandes ◽  
Ana Rita Mateus Loureiro ◽  
Maria João Diogo Obrist ◽  
César Prudente

Internal hernias are a rare cause of bowel obstruction (1%) and can be caused by broad ligament defects in 4% to 7% of the cases. These defects may be congenital or acquired and are classified according to its anatomical location. This paper reports three cases of small bowel obstruction by broad ligament hernia. The patients, three women aged from 35 to 51 years old, were admitted to the emergency department with small bowel obstruction. An exploratory laparotomy was performed during which an internal hernia through a broad ligament defect was identified. In all cases the hernia content was reduced and the defect closed. One of the patients required a segmental enterectomy. All patients had a favorable outcome. This paper aims to raise awareness about the broad ligament hernia as a cause of bowel obstruction, namely in middle-aged women with no surgical history.


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