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花生植物性胃石:小肠梗阻的罕见病因。

Peanut phytobezoar: an unusual cause for small bowel obstruction.

作者信息

Sealey Andrew J, Lau Ngee-Soon

机构信息

General Surgery, Canberra Health Services, Yamba Drive, Garran 2605, Australia.

出版信息

J Surg Case Rep. 2024 Aug 28;2024(8):rjae564. doi: 10.1093/jscr/rjae564. eCollection 2024 Aug.

Abstract

Bezoars are indigestible masses of material forming within the gastrointestinal system. Phytobezoars are the most common subtype consisting of plant matter such as fibre, skins, and seeds. Rarely they present causing small bowel obstruction (SBO) and may be difficult to distinguish from faecalization on imaging. Here we present the case of a man in his 70s who rapidly consumed an expiring bag of peanuts and subsequently developed a SBO due to formation of a peanut phytobezoar. After failing conservative management, he required emergency surgery with intentional enterotomy to milk out the bezoar. This case highlights the importance of maintaining a broad differential and thorough history taking in patients presenting with SBO.

摘要

胃石是在胃肠道系统内形成的无法消化的物质团块。植物性胃石是最常见的亚型,由纤维、果皮和种子等植物物质组成。它们很少会导致小肠梗阻(SBO),在影像学上可能难以与粪块相区分。在此,我们报告一例70多岁男性的病例,该患者迅速食用了一袋即将过期的花生,随后因花生植物性胃石的形成而发生小肠梗阻。保守治疗失败后,他需要接受急诊手术,通过故意肠切开术挤出胃石。该病例强调了对小肠梗阻患者保持广泛鉴别诊断和详细病史询问的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2ebc/11358060/8a324d647436/rjae564f1.jpg

相似文献

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Peanut phytobezoar: an unusual cause for small bowel obstruction.花生植物性胃石:小肠梗阻的罕见病因。
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本文引用的文献

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Review of the diagnosis and management of gastrointestinal bezoars.胃肠道粪石的诊断与管理综述
World J Gastrointest Endosc. 2015 Apr 16;7(4):336-45. doi: 10.4253/wjge.v7.i4.336.
7
Small-bowel bezoar versus small-bowel feces: CT evaluation.小肠粪石与小肠粪便:CT评估
AJR Am J Roentgenol. 2008 Nov;191(5):1465-8. doi: 10.2214/AJR.07.4004.
8
An unusual suspect: coconut bezoar after laparoscopic Roux-en-Y gastric bypass.
Obes Surg. 2008 Jun;18(6):756-8. doi: 10.1007/s11695-007-9343-4. Epub 2008 Mar 18.
9
Small-bowel obstruction secondary to bezoar impaction: a diagnostic dilemma.胃石嵌顿继发小肠梗阻:诊断难题
World J Surg. 2007 May;31(5):1072-8; discussion 1079-80. doi: 10.1007/s00268-006-0619-y.

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