[Food-induced ileus associated with intraperitoneal adhesions]

Six patients were treated for food ileus within a three-year period. In three patients an obstructing phytobezoar (made up of bran, sauerkraut and pumpkin in one case each) was removed at surgery from the small intestine. In three other patients ingestion of a grapefruit, bran and turnip led to an ileus, which lasted for 3-9 days but responded to conservative treatment after 3-9 days. The common finding in all six patients was severe intraperitoneal adhesions of the small intestine (after repeated laparotomies in five, due to Crohn's disease in one). A high content of indigestible roughage in food, antacidity in conjunction with disordered gastric emptying are predisposing factors in phytobezoar formation. In addition to these well documented factors, intraperitoneal adhesions after laparotomy should also make one think of phytobezoar formation. In these circumstances gastrointestinal disorders are not rarely produced by spontaneously expelled phytobezoars. Even a complete ileus can sometimes be successfully treated by conservative measures.