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Duodenal-Jejunal Bypass Surgery in Diet-Induced Obese Diabetic Mice

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Obstructing phytobezoar arising from proximal jejunal diverticulum.

Erik Lough¹, Bryan Richmond, Damian Maxwell

¹West Virginia University School of Medicine, WV, USA.

American Journal of Surgery

|December 18, 2007

Summary

A rare case of small bowel obstruction occurred due to a phytobezoar. This bezoar formed in a jejunal diverticulum, dislodged, and caused obstruction and perforation in the terminal ileum.

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Area of Science:

Gastroenterology
Surgical Pathology

Background:

Small bowel obstruction is a common surgical emergency.
Phytobezoars, indigestible masses of plant material, can cause gastrointestinal obstruction.
Jejunal diverticula are uncommon and can be a site for bezoar formation.

Observation:

A large phytobezoar was found to have formed within a proximal jejunal diverticulum.
The phytobezoar dislodged from the diverticulum and migrated distally.
The phytobezoar became impacted in the narrow terminal ileum, proximal to the ileocecal valve.

Findings:

The impacted phytobezoar led to complete small bowel obstruction.
The obstruction resulted in subsequent bowel perforation.
This case highlights a rare etiology and mechanism of phytobezoar-induced obstruction.

Implications:

Understanding bezoar formation in jejunal diverticula is crucial for diagnosis.
Early recognition and intervention can prevent complications like perforation.
This case serves as an important educational example for clinicians managing gastrointestinal emergencies.