A rare case of left colonic obstruction: Cloth fiber bezoar

Gathwal, Chiranjeev Kumar; Gathwal, Monika; Kk, Singh; Arya, Anubhav

doi:10.37549/ar2234

Cited by 3 publications

(2 citation statements)

References 18 publications

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“…Reportedly, plain radiography could identify bezoars in only 10% of patients. [10,11] Fortunately, our case was promptly diagnosed with plain radiograph. Computed tomography scan was further performed to gather extra details for surgery.…”

Section: Discussionmentioning

confidence: 71%

“…Hence, laparotomy was needed for the diagnosis and treatment. [10] Another case of primary colonic obstruction was due to a cloth fiber bezoar obstructing the left colon, it was also not diagnosed by radiographs alone and thus required surgery. [11] Conventional abdominal radiographs are usually enough to detect bowel obstruction; however, it is difficult to reach a definite diagnose regarding the cause of obstruction on plain radiographs alone.…”

Section: Discussionmentioning

confidence: 99%

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An unusual cause of acute abdomen: Massive amounts of foreign-body bezoar

Addalla

Sunni

Bukrah

et al. 2018

Ibnosina Journal of Medicine and Biomedical Sciences

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Case Report introductionAggregates of undigested or partially digested materials that could be found within the body or more specifically within the gastrointestinal (GI) tract are known as "Bezoars." [1,2] Although more commonly found in the stomach, they can also be found in the small and large intestines or even less frequently in the rectum. [3] Bezoars are classified according to their composition into five types. In decreasing order of frequency, they are phytobezoars (composed of undigested vegetable fibers), [4] diospyrobezoars (a type of phytobezoars comprised persimmon fruit), [4] trichobezoars (associated with trichotillomania known as the Rapunzel Syndrome), [4,5] pharmacobezoars (also known as drug bezoars and made up of accumulated undigested medications; [4] ), and lactobezoars (made up of milk proteins and mucus. [4] Foreign-body bezoars could be anything from plastic to foams, metals, or even worms such as ascaris. [4] Only a few papers were published in the literature regarding foreign-body bezoars in large intestines that were linked to psychiatric patients, even less so, case reports of bezoars being administrated orally as well as rectally.Acute abdomen, especially in psychiatric patients, can result from bizarre causes such as bezoars. This unique case report intends to shed light on a rare type of bezoars with an unusual presentation. A 30-year-old schizophrenic male, who is in denial of his mental condition and having mystical believes instead, presented with acute abdomen. Workups revealed vast amounts of foreign bodies within dilated intestines. Exploratory laparotomy was done extracting about 2 kg of nylon-wrapped foreign bodies which caused distention with multiple perforations to both cecum and sigmoid colon. Interestingly, the foreign materials were either ingested or introduced rectally. Although bezoars are not a common finding nowadays. They should still be considered as a potential cause of acute abdomen in psychiatric and some nonpsychiatric patients alike, especially in countries, where mental illness can easily be disguised as mystical beliefs.

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Section: Discussionmentioning

confidence: 71%

Section: Discussionmentioning

confidence: 99%

An unusual cause of acute abdomen: Massive amounts of foreign-body bezoar

Addalla

Sunni

Bukrah

et al. 2018

Ibnosina Journal of Medicine and Biomedical Sciences

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Mango seed causing acute large bowel obstruction in descending colon-world’s first reported case

Islam

Saroop

Bheem

et al. 2018

International Journal of Surgery Case Reports

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HighlightsPhytobezoars are a rare cause of large bowel obstruction.It should be included in the differentials in patients with no specific symptoms and signs of colorectal cancers.Conservative and or Colonoscopic approach should be attempted first, in all patients with no signs of peritonitis.Patients who present in an acute setting with signs of peritonitis require laparotomy even when the diagnosis is a benign phytobezoar.

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