Small-Bowel Bezoar Versus Small-Bowel Feces: CT Evaluation

Abstract

In cases of SBO, although some CT features of bezoars and small-bowel feces overlap, a well-defined mass mottled with gas bubbles associated with an encapsulating wall, the newly described "floating fat-density debris" sign, and a lesion in the stomach that appears similar to the obstructing mass is typical of a small-bowel bezoar; an isolated amorphous mass mottled with gas bubbles is typical of small-bowel feces.

Imaging differentiation of phytobezoar and small-bowel faeces: CT characteristics with quantitative analysis in patients with small- bowel obstruction

“…Because most patients with adhesioninduced SBO do not require emergency surgery, decisionmaking in such patients should focus on identifying whether SBO is accompanied by irreversible strangulation, bowel perforation, or ischaemia. The presence of the "small-bowel faeces" sign, however, is a negative sign for surgical intervention because the accumulation of small-bowel faeces has been suggested to be a chronic and possibly reversible course of obstruction [5,6].…”

“…Differing from an impacted phytobezoar, the treatment of SBO patients with small-bowel faeces is usually conservative. Preoperative imaging differentiation is important, because the indistinguishable symptoms and the treatment strategies are completely different [5,6].…”

“…Prior studies have found that phytobezoars, with the characteristic features of intraluminal debris containing air bubbles in its interstices, a mottled appearance, soft-tissue attenuation, and location at the site of the obstruction, are often discovered by MDCT [5]. Unfortunately, the previously mentioned "small-bowel faeces" sign has overlapping MDCT features [5,7,9]. There are only two previous studies comparing the similarities and differences of the MDCT features of phytobezoars and the "small-bowel faeces" sign, with only morphological assessment of the both groups.…”

“…There are only two previous studies comparing the similarities and differences of the MDCT features of phytobezoars and the "small-bowel faeces" sign, with only morphological assessment of the both groups. Delabrousse et al [5] first reported that the presence of an encapsulating wall and floating fat-density debris were found more frequently in phytobezoar patients than in smallbowel faeces patients. Kim et al [10] noted that small-bowel faeces were more tubular in shape and did not have an encapsulating wall on MDCT.…”

Computed Tomography Findings of Small Bowel Obstruction due to Bezoar Impaction: A Case Series

“…By contrast, small bowel bezoars are well-defined, focal, ovoid, intraluminal masses with mottled gas patterns at the obstruction site [4,5,11]. Moreover, small bowel bezoars are typically found at the transition zone between dilated and collapsed small bowel loops, whereas small bowel feces appear to be in dilated small bowel loops [12].…”