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Trapped In Transit - A Case Report of a Pediatric Gastric Bezoar Causing Intermittent Small Bowel Obstruction
Jonah A Frueh1, Arinzechukwu M Obegolu2, Anil G Rao3
1Advocate Christ Medical Center, Department of Emergency Medicine, Oak Lawn, IL.
Summary
A rare pediatric case involved a gastric bezoar fragmenting spontaneously, causing intermittent small bowel obstruction. Surgical removal was successful, highlighting this uncommon cause of abdominal emergencies for emergency medicine providers.
Area of Science:
- Pediatric Gastroenterology
- Abdominal Imaging
- Surgical Management
Background:
- Gastric bezoars are rare in children, typically presenting with vague symptoms.
- Spontaneous fragmentation of a gastric bezoar is an exceptionally uncommon event.
- Bezoars can lead to significant gastrointestinal complications, including bowel obstruction.
Purpose of the Study:
- To report a unique case of a pediatric gastric bezoar that spontaneously fragmented.
- To illustrate the characteristic imaging findings associated with bezoar fragmentation.
- To improve emergency medicine providers' recognition of this rare cause of abdominal mass and small bowel obstruction.
Main Methods:
- Case report of a 14-year-old female presenting with abdominal pain and vomiting.
- Physical examination revealed a palpable abdominal mass.
- Computed tomography (CT) scan was utilized for diagnosis and characterization of the mass and obstruction.
Main Results:
- CT scan identified a fragmented gastric bezoar causing intermittent small bowel obstruction.
- The patient underwent successful surgical removal of the bezoar.
- The obstruction resolved spontaneously between imaging and surgical intervention.
Conclusions:
- Spontaneous bezoar fragmentation is a rare but critical diagnosis in pediatric emergency medicine.
- Recognition of imaging findings is key for timely management of bezoar-induced bowel obstruction.
- This case underscores the importance of considering unusual etiologies for abdominal emergencies in children.
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