Small intestinal obstruction caused by the gastric bezoars in elderly diabetic patients: A case report

作者：Yifan Huang, Jie Meng, Shuo Zhang · 发表于：International Journal of Surgery Case Reports · 年份：2024 · DOI：10.1016/j.ijscr.2024.110761 · 被引用次数：5 · 研究领域：Intestinal and Peritoneal Adhesions、Omental and Epiploic Conditions、Biliary and Gastrointestinal Fistulas

INTRODUCTION: Bezoar is an unusual cause of small bowel obstruction accounting for 0.4-4 % of all mechanical bowel obstruction. With the rising incidence of diabetes and the associated risk of gastrointestinal issues. CASE PRESENTATION: A 59-year-old female diabetic patient with no prior surgical history presented with severe nausea, vomiting, and abdominal pain. CT scan revealed dilated small bowel loops, and endoscopy showed gastric retention with an impacted fecalith in the descending duodenum. At exploratory laparotomy, a bezoar was found impacted in jejunum 5-6 in. away from the Treitz ligament and was removed through an enterotomy. CLINICAL DISCUSSION: The discussion highlights the rarity of bezoar-induced small bowel obstruction and the diagnostic challenges it presents. Despite its low incidence, it is essential to consider phytobezoars in the differential diagnosis of small bowel obstruction, especially in middle-aged to older adult diabetic patients. The case underscores the importance of a detailed patient history and the use of imaging modalities such as computed tomography (CT) for accurate diagnosis. Early intervention is critical to prevent serious complications like bowel ischemia or perforation. When conservative treatments are ineffective, surgical intervention becomes necessary. CONCLUSION: Bezoar-induced small bowel obstruction remains an uncommon diagnosis. A detailed patient history and appropriate imaging are vital for timely diagnosis. It should be sus...