Recurrent Phytobezoar Presenting with Small Bowel Obstruction
*Corresponding author: Louise Dunphy, Department of Surgery, Wexham Park Hospital, Slough, UK, E-mail:
Louise.Dunphy@doctors.org.uk
Citation: Louise Dunphy, Syed Hussain Abbas and Stephen Baxter, et al. Recurrent Phytobezoar Presenting with Small Bowel Obstruction.
Clin Image Case Rep J. 2019; 1(1): 105.
Small bowel obstruction is a common presentation to the emergency department, with causes including adhesions, hernia,
malignancy, volvulus or complications of inflammatory bowel disease such as a stricture in Crohn’s disease. Indeed, it accounts
for 20% of hospital admissions annually. Phytobezoars are a concentration of poorly digested fruit such as orange pith or pulp
and vegetable fibres found in the alimentary tract in patients with a history of previous surgery or persimmon in patients without
[1]. Small bowel phytobezoars are rare and are almost always obstructive. They pose a diagnostic and management challenge.
They can form in individuals with an underlying small bowel disease such as Crohn’s or they can develop secondarily in areas
of stagnation within a dilated bowel segment. They are commonly associated with patients who have impaired gastric motility
as a result of prior gastric surgery or gastroparesis. Phytobezoar should also be suspected in patients with an increased risk of
bezoar formation, such as those individuals with a history suggestive of a high fibre intake and a poor dentition. The authors
present the case of a 73 year old female with recurrent phytobezoar caused by vegetative matter. She underwent a laparotomy,
adhesiolysis, enterotomy and incisonal hernia repair. Her postoperative recovery was complicated by hypertension. The authors
provide an overview of the aetiology, clinical presentation and management of phytobezoars.
Keywords: Phytobezoar; Small bowel obstruction; Adhesions; Hernia; Malignancy
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