Small Bowel Obstruction by a Phytobezoar in a Patient With Previous Antrectomy and Billroth II Reconstruction

A phytobezoar is a conglomerate of improperly digested fruit and vegetable debris, its development associated, amongst other factors, with previous gastric surgery. Most phytobezoars remain asymptomatic are incidentally found during imaging or interventional procedures. However, in some patients, they can cause small bowel obstruction, which subsequently lead to severe complications. Although the clinical findings similar causes intestinal there particular diagnostic treatment features more specific phytobezoars. We present case an 85-year-old man history antrectomy Billroth II reconstruction who came emergency department bilateral aspiration pneumonia obstruction due bezoar. The CT scan showed inferior lobe pulmonary consolidation, as well marked dilation gas-fluid levels transition normal caliber terminal ileum, where oval mottled-appearing mass suggesting bezoar was present. An urgent laparotomy confirmed diagnosis, enterotomy removal performed. Phytobezoars must be considered particularly when patients have Its radiological findings, scans, should appreciated establish diagnosis promptly. requires surgery most time, surgeon bear mind need look for existence bezoars gastrointestinal tract prevent reoccurrence.