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Article Details
Case Report
Volume 1, Issue 1 (November Issue)

Recurrent Phytobezoar Presenting with Small Bowel Obstruction

Louise Dunphy*, Syed Hussain Abbas and Stephen Baxter Department of Surgery, Wexham Park Hospital, UK 
 
*Corresponding author: Louise Dunphy, Department of Surgery, Wexham Park Hospital, Slough, UK, E-mail: Louise.Dunphy@doctors.org.uk 
 
Received: October 23, 2019; Accepted: November 02, 2019; Published: November 12, 2019 

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.

Abstract

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