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Intestinal obstruction due to phytobezoars.
S Chittmittrapap1, C Tanphiphat
1Department of Surgery, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Summary
Phytobezoar obstruction in the small bowel requires surgery in adults with prior gastric operations but can be managed conservatively in children with a history of excessive fruit or seed consumption.
Area of Science:
- Gastroenterology and Surgery
- Pediatric Gastroenterology
Background:
- Phytobezoars, indigestible concretions of plant matter, can cause small bowel obstruction.
- Adult patients with prior laparotomies, especially gastric surgery, are at risk.
- Children with a history of excessive fruit/seed intake may develop phytobezoars.
Purpose of the Study:
- To report cases of phytobezoar obstruction in adults and children.
- To differentiate diagnostic and treatment approaches based on patient demographics and history.
Main Methods:
- Retrospective review of seven adult and four pediatric cases with phytobezoar obstruction.
- Analysis of patient history, surgical interventions, and treatment outcomes.
Main Results:
- Adults required surgery due to suspected phytobezoar obstruction; abnormal gastric function was a predisposing factor.
- Children's obstructions were incomplete and resolved with conservative management, including colonic washouts.
- Dietary history was crucial for diagnosing phytobezoars in children.
Conclusions:
- Surgeons must consider phytobezoar obstruction in adults with a history of gastric surgery.
- Conservative management is effective for pediatric phytobezoar obstruction, avoiding surgery.
- Thorough dietary history is essential for prompt diagnosis and appropriate treatment in children.