A proximal duodenal phytobezoar with gastric outlet obstruction: Sonographic appearance

Color Doppler Twinkling Artifacts in Small-Bowel Bezoars

“…The presence of air in the biliary tree or thickening of the gallbladder wall are clues of gallstone ileus. 10 Sonographic findings of small-bowel tumors containing calcifications may resemble those of bezoars, and twinkling artifacts can also be produced. However, small-bowel tumors containing calcifications are rare 5 and may be associated with real blood flow on color Doppler imaging.…”

“…5 Small-bowel bezoars are a cause of small-bowel obstruction, and some reports have described their sonographic findings. [6][7][8][9][10] However, obstructed small-bowel loops usually contain a large amount of air, and bezoars can be overlooked if sonographic examinations are not performed meticulously. Recently, we had 3 cases of small-bowel bezoars obstructing the small-bowel loops, which showed twinkling artifacts during color Doppler sonographic examinations.…”

“…Recently, we had 3 cases of small-bowel bezoars obstructing the small-bowel loops, which showed twinkling artifacts during color Doppler sonographic examinations. To the best of our knowledge, although several reports have mentioned the sonographic findings of small-bowel bezoars, [6][7][8][9][10] an association between twinkling artifacts and small-bowel bezoars has not been described previously.…”

Phytobezoars in the Small Intestine: CT and US Appearances

“…Sonogaphically, phytobezoars were seen as an intraluminal mass with a hyperechoic arc-like surface echo casting a clear posterior acoustic shadow, as described in several case reports (4,5,9). The obstructed small bowelloops usually contained a large amount of air, and so phytobezoars could be overlooked if sonographic examination was not meticulously performed .…”

“…It has been recognized that phytobezoar formation is common after a gastric operation, and causes gastric ulceration, bleeding, and gastrointestinal obstruction. Phytobezoars are likely to pose diagnostic difficulties in surgical patients when they enter into the differential diagnosis of disorders that cause abdominal pain and small bowel obstruction, particularly in patients who have previously undergone a gastric operation.Several reports have described the radiographic findings of phytobezoar after the administration of a barium study, but few have described ultrasound (US) appearances (3,4,5). To evaluate the usefulness of US and CT in diagnosing this entity, this report reviews the US and CT features ofsmall intestinal phytobezoars m SIX patlents.…”