Intestinal Obstruction Caused by Recurrent Phytobezoar: Resolved With Non-surgical Treatment With Cellulase

Delgado, Manuel Carreira; Rodríguez, Elvira Fernández; Vázquez-Garza, José Manuel Nuño; Llorens, Carlos Gil; López, Cuauhtémoc Romero

doi:10.1016/j.cireng.2012.07.006

Cited by 1 publication

(1 citation statement)

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“…Numerous medical therapies have been attempted with success in clearing phytobezoars, including Coca Cola, [ 26 - 28 ], Adolph's Meat Tenderizer, [ 29 ] Lcysteine, cellulase, [ 30 , 31 ] cellulase with metoclopramide, [ 32 ] papain, [ 31 ] water jet, pineapple juice, normal saline, 0.1 M hydrochloric acid, sodium bicarbonate, pancrealipase, pancreatin, and 12% zinc chloride [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

PhytobezoarInduced Small Bowel Obstruction in a Young Male with Virgin Abdomen

Manning

Vattipallly

Niazi

et al. 2015

J Gastrointest Dig Syst

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Phytobezoars are a rare cause of small bowel obstruction. Such cases are most commonly associated with previous abdominal surgery or poor dentition or psychiatric conditions. A 40 year old man with a virgin abdomen and excellent dentition and no underlying psychiatric condition presented with an acute abdomen. CT scan revealed a transition point between dilated proximal loops of small bowel and collapsed distal loops. Exploratory laparotomy revealed a phytobezoar unable to be milked into the cecum and an enterectomy with primary anastamosis was performed without complication. A detailed history revealing several less common predisposing factors for phytobezoars should increase clinical suspicion of a phytobezoarinduced small bowel obstruction in the setting of an acute abdomen. Vigilance in presentations of an acute abdomen improves the usefulness of medical imaging, such as a CT, to detect phytobezoars. Understanding mechanisms of phytobezoar formation helps guide management and may prevent surgery.

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