Simultaneous gastric outlet and small bowel obstruction due to phytobezoar: a rare case report

Small bowel obstruction is a common surgical problem with a wide variety of causes, although bezoars are a rare etiology. Among them, phytobezoars, composed of undigested vegetable or fruit fibers, are the most frequent type. Their clinical presentation often mimics more common causes of intestinal obstruction, making accurate diagnosis challenging. We report the case of a 78-year-old woman who presented with an 8-day history of abdominal pain, nausea, and vomiting. Imaging revealed both gastric outlet and small bowel obstruction. At laparotomy, two phytobezoars were identified and successfully removed from the stomach and ileum. The patient recovered well and was discharged on postoperative day 6. This case highlights the importance of considering bezoars as a differential diagnosis in intestinal obstruction, as management may be surgical or conservative depending on the circumstances.