S2175 Now You See Me, Now You Don’t: A Case of Campylobacter Jejuni Colitis Presenting as a Colonic Mass

Abstract

Discussion: Bezoars are collections of indigestible foreign material accumulated and conglomerated in different locations throughout the gastrointestinal tract, however, they are most commonly found in the stomach . Bezoars are divided into 4 groups according to their combination, including phytobezoars, trichobezoars, pharmacobezoars and lactobezoar. Among the 4 types of bezoars, phytobezoars are the most common. Bezoars from fruits and vegetables tend to accumulate in the stomach, however, seed bezoars, due to their small size, pass the pylorus more easily and tend to form an impaction either in colon and rectum. The diagnosis of seed bezoars is based on careful history and digital rectal examination. However, imaging scans help physicians to diagnose seed bezoar in the small intestine and colon which require further investigations. The most frequently seen CT findings of bezoars include the appearance of a round or ovoid or a long sausage-shaped mass containing mottled gas at the obstructed site. Treatment and evacuation of phytobezoar is based on its location in the gastrointestinal tract. The currently available treatment options for phytobezoar include dissolution of the bezoar by Coca-Cola, papain, cellulase, removal by endoscopic devices, laparotomy, and laparoscopic surgery.