Cotton Bezoar- a rare cause of intestinal obstruction: case report

Abstract

BackgroundBezoars usually present as a mass in the stomach. The patient often has a preceding history of some psychiatric predisposition. Presentation could be in the form of trichophagy followed by trichobezoar (swallowing of hair leading to formation of bezoar), orphytobezoar (swallowing of vegetable fibres). Rapunzel syndrome is a condition where the parent bezoar is in the stomach and a tail of the fibres or hair extends in to the jejunum. Presentation as intestinal obstruction due to a bezoar in the intestine without a parent bezoar in the stomach is rare, therefore we report it here.Case reportA 35 year old lady tailor with a previous history of receiving treatment for depression on account of being infertile- years after her marriage, presented to the surgical emergency department with features of acute intestinal obstruction. Exploratory laparotomy and enterotomy revealed a cotton bezoar in the terminal ileum without a parent bezoar in the stomach. She was managed by resection of the affected segment of the ileum and end-to-end anastomosis of the bowel. In the postoperative period the patient gave a history of ingesting cotton threads whenever she was depressed.ConclusionPresence of cotton bezoar is rare and an intestinal bezoar in the absence of parent bezoar in the stomach is still rarer.

Intestinal Phytobezoar: A Rare Case Report

“…were also on record. [11][12][13][14][15] The stomach is the most common site of bezoar formation, followed by the small intestine and, rarely, the colon or rectum. 16,17 Among all type of bezoar phytobezoars are the most common type and formed by excessive consumption of herbal nutrients containing high amounts of indigestible fibers, such as cellulose, hemicellulose, lignin and fruit tannins.…”

A non-occlusive bezoar of caecum in a 7-year-old child: ultrasound detection and multimodality imaging management

“…[4,5]. Thrichobezoars and lithobezoars are usually demonstrated in children and teens with prevalence for young women with long hair (90 %) [6] and psychiatric predisposition [7]. Phytobezoars are most common in the elderly patients with inadequate food intake and chronic constipation.…”

Trichobezoar in the absence of trichotillomania: a consequence of occupational hazard

“…1 Most of the cases of trichobezoars are described in adolescent girls/young females. 2,3 The first description of postmortem human bezoar was by swain 1854.…”