Ezzat Rajan Fuad, Rashid Shahzad Ali, Rashid Abbas Tahir, Abdullah Khaled Musttafa, Ahmed Shyaw Mahmood
Department of Surgery, Sulaimanyah Teaching Hospital, Sulaimanyah, Iraq.
J Med Case Rep. 2009 Dec 2;3:9312. doi: 10.1186/1752-1947-3-9312.
Patients with mechanical small-bowel obstructions usually present with abdominal pain, vomiting, absolute constipation and varying degrees of abdominal distention. Causes can be classified as benign or malignant, or as extra- or intraluminal. A bezoar occurs most commonly in patients with impaired gastrointestinal motility. In edentulous older patients with abnormal food habits, it can also be an intestinal concretion that fails to pass along the alimentary canal. Small bowel phytobezoars are rare and almost always obstructive. In a normal stomach, vegetable fibres that cannot pass through the pylorus undergo hydrolysis within the stomach, which softens them enough to go through the small bowel. We present an unusual case of small intestinal obstruction caused by a phytobezoar in a patient who had neither a history of gastric surgery nor of intestinal pathology.
A 70-year-old Iraqi Kurdish man was hospitalized due to abdominal pain, vomiting and dehydration. Investigations concluded small intestinal obstruction. Subsequent laparotomy revealed that the cause of the obstruction was an eggplant phytobezoar.
Many types of bezoar can be removed endoscopically, but some will require operative intervention. Subsequently, prevention of any recurrence should be emphasized.
机械性小肠梗阻患者通常表现为腹痛、呕吐、完全性便秘以及不同程度的腹胀。病因可分为良性或恶性,或腔外或腔内病因。胃石最常见于胃肠动力受损的患者。在无牙的老年患者中,若饮食习惯异常,胃石也可能是未能通过消化道的肠内结石。小肠植物性胃石罕见,且几乎总是导致梗阻。在正常胃中,无法通过幽门的植物纤维会在胃内发生水解,从而软化到足以通过小肠。我们报告一例由植物性胃石引起的小肠梗阻的罕见病例,该患者既无胃手术史也无肠道病史。
一名70岁的伊拉克库尔德男子因腹痛、呕吐和脱水入院。检查诊断为小肠梗阻。随后的剖腹手术显示梗阻原因是茄子植物性胃石。
许多类型的胃石可通过内镜取出,但有些需要手术干预。随后,应强调预防任何复发情况。