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Phytobezoar in Meckel's diverticulum: A rare cause of small bowel obstruction

Roberto Bini1, Fabrizio Quiriconi, Aurelio Tello

  • 1Dept of General and Emergency Surgery, Ospedale SG Bosco, Piazza Donator di Sangue 3, Torino 10159, Italy.

International Journal of Surgery Case Reports
|March 3, 2012
PubMed
Abstract

Insights

A rare case of intestinal obstruction caused by a phytobezoar within a Meckel

Area of Science:

  • Gastroenterology and General Surgery
  • Surgical Pathology

Background:

  • Meckel's diverticulum (MD) is a common congenital anomaly of the gastrointestinal tract, typically asymptomatic.
  • Phytobezoars, concretions of undigested plant fibers, can cause gastrointestinal obstruction.
  • Intestinal obstruction from a phytobezoar within an MD is an exceptionally rare occurrence.

Purpose of the Study:

  • To report a rare case of small intestinal obstruction.
  • To highlight the diagnostic and management challenges of phytobezoar formation in Meckel's diverticulum.

Main Methods:

  • A 50-year-old patient presented with symptoms of small bowel obstruction.
  • Diagnostic imaging included plain X-rays and contrast-enhanced computed tomography (CT).
  • Surgical intervention via explorative laparotomy was performed, followed by segmental ileal resection.

Main Results:

  • CT scan revealed jejunal loops with air-fluid levels, suggestive of obstruction.
  • Explorative laparotomy identified a large phytobezoar within a Meckel's diverticulum causing compression.
  • Histological examination confirmed the presence of Meckel's diverticulum.

Conclusions:

  • Phytobezoar formation within a Meckel's diverticulum leading to bowel obstruction is exceedingly rare, with only a handful of cases documented.
  • While conventional X-rays were inconclusive, contrast-enhanced CT proved definitive in diagnosis.
  • Exploratory laparotomy or laparoscopy is essential for managing such rare complications.

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