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Small-bowel carcinoid presenting in association with a phytobezoar
J W Lorimer1, M W Allen, H Tao
1Department of Surgery, Ottawa General Hospital, Ont.
Canadian Journal of Surgery. Journal Canadien De Chirurgie
|August 1, 1991
Summary
A rare case of recurrent small-bowel obstruction after surgery was caused by a phytobezoar and a carcinoid tumor. Small-bowel imaging is crucial for diagnosing such unusual obstructions.
Area of Science:
- Gastroenterology
- Radiology
- Surgical Pathology
Background:
- Recurrent small-bowel obstruction can present diagnostic challenges, particularly in the postoperative setting.
- Carcinoid tumors of the small bowel can lead to luminal narrowing and complications.
- Phytobezoars, composed of indigestible plant matter, are an uncommon cause of intestinal obstruction.
Observation:
- A patient presented with recurrent, postoperative small-bowel obstruction.
- Imaging revealed a mobile, intraluminal filling defect (phytobezoar) proximal to a fixed mural mass.
- The mural mass was identified as a primary carcinoid tumor of the small bowel.
Findings:
- The phytobezoar was located proximally to the carcinoid tumor.
- Radiologic findings included a mobile intraluminal filling defect and a distal fixed mural mass.
- The obstruction mechanism was likely a "ball-valve" effect of the phytobezoar at the carcinoid-induced stenosis.
Implications:
- This case highlights the importance of considering phytobezoars in the differential diagnosis of recurrent small-bowel obstruction.
- Small-bowel imaging plays a vital role in identifying the underlying causes of repeated obstructions.
- Understanding the interplay between phytobezoars and tumors is crucial for effective management.