An Uncommon Cause of Small Bowel Obstruction: Bezoar

We report the case of an elderly male who was presented with abdomen pain and diagnosed of small bowel obstruction caused by bezoar and review the literature. The initial presentation was epigastralgia with nausea and vomiting. Plain abdomen film showed diffuse dilated bowel loop. Both abdomen ultrasound and computed tomography all showed an intraluminal mass with bowel dilatation. Due to failure of conservative treatment, laparotomy was performed. Bezoar was fragmented and milked into cecum. The patient was recovered smoothly and discharged from our hospital. Therefore, it is a reminder that if conservative treatment of small bowel obstruction is failure, surgical intervention can be performed smoothly by laparoscopy without enterotomy. Early recognition with typical symptom and image findings play an important role in minimizing the morbidity and mortality. (J Intern Med Taiwan 2012; 23: 119-123)