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Multiple gastrointestinal bezoars leading to perforation peritonitis: A case report
Kishor Kumar Deo1, Prajwala Yogi2, Dhirendra Rokaya3
1Department of Surgery, National Academy of Medical Sciences, Bir Hospital, Kathmandu, Nepal.
Introduction And Importance:
Metal bezoars are a rare form of bezoars that are commonly found in the stomach and may also be found on other parts of the gastrointestinal tract. This condition is mostly associated with psychiatric patients, which is a challenging task for diagnosis and treatment. Only a few cases of large metal bezoars are documented till date.
Case Presentation:
We report a case of an 18-year-old male with a history of psychiatric condition who presented to the emergency department with symptoms of hollow viscus perforation and peritonitis after intentionally ingestion of multiple metal bezoars. Radiographic findings revealed multiple metallic objects, a dilated stomach, and free air under the diaphragm bilaterally. An emergency exploratory laparotomy was done, involving gastrotomy and primary repair of the gastric perforation.
Clinical Discussion:
For long-term management, medication and behavioural therapy are the essential preventive measures. This case emphasizes the importance of recognizing metal bezoars as a potential cause of gastrointestinal emergencies in psychiatric patients.
Conclusion:
Timely surgical intervention, along with comprehensive psychiatric care, is essential for successful outcomes.
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