A case report of mechanical intestinal obstruction due to phytobezoar

Abstract

Bezoars are persistent deposits of indigestible material in the digestive tract, usually located in the stomach, although they can migrate to other parts of the intestine. Although most patients are asymptomatic, accumulation over time can produce symptoms associated with obstruction of the digestive tract, ranging from partial to total occlusion. We present the case of a 58-year-old male patient, with a history of severe mental retardation, who presents in a state of severe dehydration due to abundant dark vomiting and diarrheal stools and with a slightly distended abdomen. Physical examination reveals hypotension, tachycardia, dry mucous membranes and skin fold. A hydroelectrolytic imbalance, resulted from the clinical manifestations, and an acute gastric dilatation without a definite cause are suggested. 48 after being admitted to the intensive care unit and having corrected the hydroelectrolytic imbalance, he continues with great abdominal distention. Simple abdominal X-ray shows dilation of thin loops and air-fluid levels that persist despite the measures, which is why it is presented as a mechanical intestinal obstruction without being able to determine an apparent cause. An exploratory laparotomy is performed and mechanical intestinal obstruction caused by phytobezoar is found in the small intestine. Enterotomy and extraction is performed. The patients progresses favorably and is discharged 5 days after surgery without complications.