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Obstructing small bowel bezoars due to an agar diet: diagnosis using double balloon enteroscopy
Taro Osada1, Tomoyoshi Shibuya, Tomohiro Kodani
1Department of Gastroenterology, Juntendo University School of Medicine, Tokyo, Japan. otaro@med.juntendo.ac.jp
Internal Medicine (Tokyo, Japan)
|April 2, 2008
Summary
Primary small bowel bezoars are rare but can cause acute abdomen. This case highlights agar bezoars causing small bowel obstruction in a 70-year-old woman, requiring surgical intervention.
Area of Science:
- Gastroenterology
- Surgical Case Reports
Background:
- Primary small bowel bezoars are uncommon gastrointestinal masses.
- They can lead to significant complications, including small bowel obstruction (SBO).
Observation:
- A 70-year-old woman presented with acute abdominal pain, nausea, and vomiting.
- She reported recent consumption of highly concentrated, dissolved agar.
- Diagnostic imaging and double balloon enteroscopy (DBE) revealed jejunal obstruction by bezoars.
Findings:
- Surgical exploration identified multiple impacted bezoars in the distal jejunum.
- The bezoars were described as elastic, hard, and crystallized.
- Etiology was attributed to the ingestion of concentrated, dissolvable agar.
Implications:
- This case underscores the potential for agar bezoars to cause acute abdominal emergencies.
- Highlights the importance of dietary history in diagnosing bezoar formation.
- Demonstrates the utility of DBE in diagnosing and managing small bowel bezoars.
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