A giant complex rectosigmoid bezoar with multiple foreign bodies: a first of its kind.

To cite: Boopathy V, Palaniswamy M. BMJ Case Rep Published online: [please include Day Month Year] doi:10.1136/bcr-2014207573 DESCRIPTION A 20-year-old male patient presented with a 15-day history of constipation, abdominal distention and abdominal pain. He was mentally impaired and would swallow foreign bodies, including pieces of clothing. His abdomen was firm and tender on examination with absent bowel sounds. Rectal examination revealed impacted stools. CT of the abdomen showed a 19×26 cm ovoid intraluminal mixed density mass with mottled gas pattern and multiple foreign bodies occupying the rectosigmoid colon consistent with a bezoar (figures 1 and 2). Digital evacuation was performed several times and the bulk of the bezoar was removed piecemeal. The major bulk was cotton thread along with different objects such as pieces of bone, seeds of various fruits, stapler pins, buttons, metal wires, etc. These were removed. Finally the patient started passing stools on his own and was discharged. A bezoar is a tightly packed mass of foreign material in the gastrointestinal tract of humans or animals. Patients with learning disabilities and psychiatric illness have increased risk of bezoar formation due to