Lu Bing-Yun, Zeng Zhi-Yu, Zhang Dong-Jing
Department of Gastroenterology, Shenzhen Hospital of Southern Medical University, Shenzhen 518100, Guangdong Province, China.
World J Radiol. 2024 Nov 28;16(11):683-688. doi: 10.4329/wjr.v16.i11.683.
Small bowel bezoar obstruction (SBBO) is a rare clinical condition characterized by hard fecal masses in the small intestine, causing intestinal obstruction. It occurs more frequently in the elderly and bedridden patients, but can also affect those with specific gastrointestinal dysfunctions. Diagnosing SBBO is challenging due to its clinical presentation, which mimics other intestinal obstructions. While surgical intervention is the typical treatment for SBBO, advancements in endoscopic techniques have led to increased use of non-surgical methods, such as endoscopic lithotripsy.
We report a case of small bowel obstruction induced by a phytobezoar. A 49-year-old male with a history of type 2 diabetes and long-term persimmon consumption presented to the hospital with symptoms of vomiting, abdominal distension, and constipation. Computed tomography revealed a small bowel obstruction with foreign bodies. Double balloon enteroscopy identified a phytobezoar blocking the intestinal lumen. The bezoar was successfully fragmented using a snare, and the fragments were treated with 100 mL of paraffin oil to facilitate their passage. This case report aims to enhance the understanding of this rare condition by detailing the clinical presentation, diagnostic process, and treatment outcomes of a patient with SBBO. Special attention is given to the application and effectiveness of non-surgical treatment methods, along with strategies to optimize patient management.
Double balloon enteroscopy combined with sequential laxative therapy is an effective approach for the treatment of a breakable phytobezoar.
小肠粪石梗阻（SBBO）是一种罕见的临床病症，其特征为小肠内有坚硬的粪便团块，导致肠梗阻。它在老年人和卧床患者中更为常见，但也可影响患有特定胃肠功能障碍的人群。由于其临床表现与其他肠梗阻相似，诊断SBBO具有挑战性。虽然手术干预是SBBO的典型治疗方法，但内镜技术的进步导致非手术方法（如内镜碎石术）的使用增加。
我们报告一例由植物粪石引起的小肠梗阻病例。一名49岁男性，有2型糖尿病病史且长期食用柿子，因呕吐、腹胀和便秘症状入院。计算机断层扫描显示小肠梗阻并伴有异物。双气囊小肠镜检查发现一个植物粪石阻塞肠腔。使用圈套器成功将粪石破碎，并用100毫升石蜡油处理碎片以促进其排出。本病例报告旨在通过详细描述一名SBBO患者的临床表现、诊断过程和治疗结果，加深对这种罕见病症的理解。特别关注非手术治疗方法的应用和有效性，以及优化患者管理的策略。
双气囊小肠镜检查联合序贯泻药治疗是治疗可破碎植物粪石的有效方法。
