Huang Yifan, Meng Jie, Zhang Shuo
School of Clinical Medical College, Hebei University, Baoding 071000, China; Department of Digestive Medicine, Affiliated Hospital of Hebei University, Baoding 071000, China.
Department of Digestive Medicine, Affiliated Hospital of Hebei University, Baoding 071000, China.
Int J Surg Case Rep. 2025 Feb;127:110761. doi: 10.1016/j.ijscr.2024.110761. Epub 2024 Dec 23.
Bezoar is an unusual cause of small bowel obstruction accounting for 0.4-4 % of all mechanical bowel obstruction. With the rising incidence of diabetes and the associated risk of gastrointestinal issues.
A 59-year-old female diabetic patient with no prior surgical history presented with severe nausea, vomiting, and abdominal pain. CT scan revealed dilated small bowel loops, and endoscopy showed gastric retention with an impacted fecalith in the descending duodenum. At exploratory laparotomy, a bezoar was found impacted in jejunum 5-6 in. away from the Treitz ligament and was removed through an enterotomy.
The discussion highlights the rarity of bezoar-induced small bowel obstruction and the diagnostic challenges it presents. Despite its low incidence, it is essential to consider phytobezoars in the differential diagnosis of small bowel obstruction, especially in middle-aged to older adult diabetic patients. The case underscores the importance of a detailed patient history and the use of imaging modalities such as computed tomography (CT) for accurate diagnosis. Early intervention is critical to prevent serious complications like bowel ischemia or perforation. When conservative treatments are ineffective, surgical intervention becomes necessary.
Bezoar-induced small bowel obstruction remains an uncommon diagnosis. A detailed patient history and appropriate imaging are vital for timely diagnosis. It should be suspected in patients with an increased risk of bezoar formation, such as in middle-aged to older adult diabetic patients or a history suggestive of increased fiber intake. CT scan is helpful for preoperative diagnosis. and highlights the need for increased awareness among clinicians regarding the management of bezoars.
胃石是小肠梗阻的一种罕见病因，占所有机械性肠梗阻的0.4%-4%。随着糖尿病发病率的上升以及相关胃肠道问题风险的增加。
一名59岁无既往手术史的糖尿病女性患者出现严重恶心、呕吐和腹痛。CT扫描显示小肠肠袢扩张，内镜检查显示胃潴留，降部十二指肠有粪石嵌顿。在剖腹探查术中，发现一枚胃石嵌顿在距屈氏韧带5-6英寸的空肠处，并通过肠切开术取出。
讨论强调了胃石所致小肠梗阻的罕见性及其带来的诊断挑战。尽管其发病率较低，但在小肠梗阻的鉴别诊断中，尤其是在中老年糖尿病患者中，必须考虑植物性胃石。该病例强调了详细的患者病史以及使用计算机断层扫描（CT）等成像方式进行准确诊断的重要性。早期干预对于预防肠缺血或穿孔等严重并发症至关重要。当保守治疗无效时，手术干预就变得必要。
胃石所致小肠梗阻仍然是一种罕见的诊断。详细的患者病史和适当的影像学检查对于及时诊断至关重要。对于胃石形成风险增加的患者，如中老年糖尿病患者或有纤维摄入增加提示病史的患者，应怀疑此病。CT扫描有助于术前诊断，并突出了临床医生对胃石管理提高认识的必要性。
