Multivitamin-Induced Pharmacobezoar: A Rare Entity of Large Bowel Obstruction

Abstract

The term bezoar refers to a foreign object found like a mass of concretion in the gastrointestinal tract that results from an accumulation of undigested material. When the composition of the ingested material is a medication, it is known as a pharmacobezoar. A rare complication from pharmacobezoar is large intestinal obstruction. Here we present the case of a 77-year-old male who presented with progressive abdominal distension, involuntary guarding, and large bowel obstruction. Abdominal imaging studies were remarkable for radiopaque objects of uncertain etiology in the transverse colon and rectal ampulla. The patient underwent colonic decompression by sigmoidoscopy, where the pills were identified by direct visualization. He later underwent endoscopic removal of the pharmacobezoars. A detailed medication review identified the culprit to be multivitamins. This case portrays an unusual etiology of large bowel obstruction. At this moment, no cases have been reported of multivitamins as the culprit of pharmacobezoar with subsequent development of large bowel obstruction.

Pharmacobezoar Masquerading as a Colon Lesion: A Sticky Situation

“…Multivitamin bezoars represent a rare phenomenon. 2 In this case, our patient presented asymptomatically with ambiguous imaging, suggesting the potential presence of a “solid lesion” vs organized bowel content. Fortunately for our patient, malignancy was excluded.…”