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BMJ Case Reports 2015; doi:10.1136/bcr-2014-208493
  • CASE REPORT

Colonic phytobezoar as a rare cause of large bowel obstruction

  1. Rebecca Thomas
  1. Division of Surgery, Lyell McEwin Hospital, Elizabeth Vale, South Australia, Australia
  1. Correspondence to Dr Diwei Lin, diwei.lin1{at}gmail.com
  • Accepted 10 March 2015
  • Published 9 April 2015

Summary

Bezoars are masses formed by the concretion of stomach contents or debris within the gastrointestinal tract. Bezoars are rare and account for only 0.4–4% of all cases of gastrointestinal obstruction and mainly occur in the stomach or small intestine. Intestinal obstruction caused by colonic bezoars is extremely rare. We report a case of a distal sigmoid obstruction caused by a phytobezoar in a 60-year-old man with no obvious precipitating causes. He presented to the emergency department acutely unwell and a subsequent abdominal CT scan showed a mass within the proximal sigmoid colon suspicious for a bezoar. He proceeded to have an urgent laparotomy and the obstructive intraluminal mass in the sigmoid colon was identified and manually broken down. Subsequent histopathological assessment reported amorphous material and plant cellular matter consistent with the diagnosis of a phytobezoar.

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