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Case report. Small bowel obstruction due to phytobezoar formation within Meckel diverticulum: CT findings
V I Frazzini1, W J English, B Bashist
1Department of Radiology, St. Luke's/Roosevelt Hospital Center, Columbia University College of Physicians and Surgeons, New York, NY 10025, USA.
Abstract:
Intestinal obstruction due to a phytobezoar within a Meckel diverticulum is exceedingly rare, with only seven reported cases in the surgical literature. The most important precipitating factor is the ingestion of agents high in fiber and cellulose. Small bowel obstruction in all but one case was due to retrograde propagation of the bezoar into the small bowel lumen. We report the clinical and CT findings in such a patient following a vegetarian diet.
Insights
Phytobezoars in Meckel diverticula causing intestinal obstruction are rare. This case highlights a patient on a vegetarian diet experiencing such an obstruction due to retrograde bezoar propagation.
Area of Science:
- Gastroenterology
- Surgical Pathology
Background:
- Meckel diverticulum is a congenital anomaly of the small intestine.
- Phytobezoars are indigestible masses formed in the gastrointestinal tract.
- Intestinal obstruction is a common surgical emergency.
Observation:
- A rare case of intestinal obstruction caused by a phytobezoar within a Meckel diverticulum is presented.
- The patient had been following a vegetarian diet, rich in fiber and cellulose.
- Computed tomography (CT) imaging was utilized to diagnose the condition.
Findings:
- Phytobezoar formation is linked to the ingestion of high-fiber and cellulose materials.
- Small bowel obstruction occurred due to retrograde propagation of the phytobezoar into the small bowel lumen.
- This presentation is exceptionally rare, with limited prior reports in surgical literature.
Implications:
- Highlights the potential for phytobezoars to form in Meckel diverticula, particularly with specific dietary habits.
- Emphasizes the importance of considering phytobezoars in the differential diagnosis of small bowel obstruction in at-risk patients.
- Suggests that dietary factors, such as high fiber intake, may predispose individuals to phytobezoar formation in this rare anatomical location.