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A Phytobezoar Causing Terminal Ileal Obstruction Following Revision Bariatric Surgery: A Case Report
Siddharth Sankar Das1, Zaid AbdelAziz1, Walid Zakaria Abdelhamid M Bondok1
1General Surgery, Dubai Hospital, Dubai, ARE.
Abstract:
Bezoars are a rare complication causing small bowel obstruction. A phytobezoar causing terminal ileum obstruction following a Roux-en-Y gastric bypass (RYGB) is extremely rare. A middle-aged woman with post-sleeve gastrectomy weight regain, converted to RYGB, presented 17 months after surgery with obstructive symptoms due to an impacted phytobezoar in the terminal ileum. Diagnostic laparoscopy, enterotomy, and extraction of the large impacted phytobezoar from the terminal ileum relieved the obstruction. Swallowing improperly masticated food in altered gastrointestinal anatomy due to RYGB can cause a phytobezoar in any part of the gastrointestinal tract. These patients need proper nutritional counseling and psychological evaluation to prevent this rare complication.
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