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Int J Surg Case Rep

Title:		"Intestinal Obstruction Secondary to Multiple Gastrointestinal phytobezoars, A Rare presentation"
Author(s):		Alsahwan AG; Almarhoon AM; AlSafwani J; Alsahwan H; Alturki N;
Address:		"Department of General Surgery, Qatif Central Hospital, Qatif, Saudi Arabia. Electronic address: Sahwan.ag@hotmail.com. Department of General Surgery, Qatif Central Hospital, Qatif, Saudi Arabia. Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia"
Journal Title:		Int J Surg Case Rep
Year:		2021
Volume:		20210521
Issue:
Page Number:		106004 -
DOI:		10.1016/j.ijscr.2021.106004
ISSN/ISBN:		2210-2612 (Print) 2210-2612 (Electronic) 2210-2612 (Linking)
Abstract:		"INTRODUCTION: Intestinal obstruction considered to be one of the most common surgical presentation. Adhesions secondary to previous operations, hernias, neoplasms, inflammatory bowel disease, intussusception, or volvulus are the usual causes of intestinal obstruction but bezoar can presents in 0.4-4%. Bezoar can be trapped in different locations throughout the gastrointestinal tract and it can be solitary or multiple lesions. CASE PRESENTATION: This is a 37-year-old male, known case of diabetes mellitus, Presented to the Emergency Department complaining of generalized abdominal pain for 2 days duration. Associated with abdominal distention, fever, nausea, vomiting and obstipation. There was a history of persimmon intake. Unremarkable past surgical history. On examination, He was tachycardic, other vital signs were within normal. Abdominal examination showed abdominal distention and Sluggish bowel sound. Abdominal X-ray revealed multiple air-fluid levels. An abdominal CT scan with IV contrast revealed an intra-luminal mass in the ileum and intra-gastric mass with suspicious of bezoars. He underwent exploratory laparotomy, gastrostomy to remove intra-gastric bezoar, and enterotomy to remove the ileal bezoar. CLINICAL DISCUSSION: Intestinal obstruction is considered to be the most common complication of this entity; other possible complications include gastric ulcer, gastritis, and gastric perforation. Due to limitations of endoscopy and barium enema in the diagnosis of bezoar, Abdominal CT-scan is considered to be the gold standard in the diagnosis. The management of phytobezoar can be either conservative or surgical, depends on the lesion size and location. CONCLUSION: Although intestinal obstruction secondary to bezoar is rare, multiple levels of gastrointestinal obstruction should raise the suspicion of bezoar"
Keywords:		Bezoar Enterotomy Gastrostomy Persimmon Phytobezoars;
Notes:		"PubMed-not-MEDLINEAlsahwan, Abdullah G Almarhoon, Ameen M AlSafwani, Jihad Alsahwan, Hanan Alturki, Neamat eng Netherlands 2021/05/31 Int J Surg Case Rep. 2021 Jun; 83:106004. doi: 10.1016/j.ijscr.2021.106004. Epub 2021 May 21"