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Gastrointestinal obstruction from phytobezoar in childhood: report of two cases
1Department of Surgery, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria.
Insights
Gastrointestinal obstruction caused by phytobezoar is rare in children. One child died from complications, while another recovered after neoanal dilatation, highlighting varied outcomes in pediatric phytobezoar cases.
Area of Science:
- Pediatric Surgery
- Gastroenterology
Background:
- Phytobezoars, indigestible masses of plant material, can cause gastrointestinal obstruction in children.
- This report details two pediatric cases of phytobezoar leading to obstruction.
Observation:
- A 27-month-old child presented with gastrointestinal obstruction due to a phytobezoar.
- A 6-year-old child with a history of anorectal malformation surgery also presented with a phytobezoar causing obstruction.
Findings:
- The younger child underwent laparotomy and gastrotomy for bezoar removal, but unfortunately succumbed to hypokalemia.
- The older child's phytobezoar, lodged above the neoanus, was successfully removed via neoanal dilatation, relieving the obstruction without recurrence.
Implications:
- This case series underscores the critical and potentially fatal nature of phytobezoars in pediatric gastrointestinal obstruction.
- Management strategies, including surgical intervention and neoanal dilatation, can be effective, but patient outcomes vary significantly.
- Further research into risk factors and preventative measures for pediatric phytobezoars is warranted.
Abstract:
This is a report of two children aged twenty seven months and six years respectively presenting with gastrointestinal obstruction from phytobezoar. In the 27-month old child, laparotomy and gastrotomy was performed to evacuate the bezoar. However, death occurred from hypokalaemia. The six-year old child had a sacro-abdomino-perineal pull through for anorectal malformation previously and the bezoar lodged just above the neoanus. Neoanal dilatation allowed removal of the bezoar and relief of the obstruction. There has been no recurrence. The literature on bezoar is briefly reviewed.