Diospyrobezoar in Jejunum Causing Intestinal Obstruction: A Rare Case Report

Yıl 2005, Cilt: 7 Sayı: 2, 29 - 32, 01.07.2005

Mehmet Yasar Arif Aslaner Taner Turgut Celalettin İçmeli Ertugrul Ertas

Öz

Bezoars present as a mass in any part of intestine usually in the stomach. Presentation could be in the form of trichophagy followed by trichobezoar (swallowing of hair leading to formation of bezoar) and orphytobezoar (swallowing of vegetable fibres). A 36 years old housewife presented to the surgical emergency department with features of acute intestinal obstruction. A detailed history taking and physical examination were made. In the preoperative period the patient gave a history of eating persimmon. Following an abdominal ultrasonography, she undergone laparotomy with the suspicion of bezoar and enterotomy revealed a diospyrobezoar in the jejunum. She was managed by a single enterotomy of the jejunum. Presence of diospyrobezoar is rare and an intestinal bezoar in the absence of parent bezoar in the stomach is still rarer

Anahtar Kelimeler

Diospyrobezoar, jejunum, intestinal obstruction, persimmon

İntestinal Obstruksiyona Neden Olan Jejunumda Diospirobezoar: Nadir bir Olgu

Öz

Bezoar sıklıkla mide olmak üzere gastrointestinal sistemin herhangi bir yerinde kitle olarak oluşabilir. Trikobezoar (saçların yutulması ile bezoar oluşumu) ve orfitobezoar (sebze liflerinin yutulması ile bezoar oluşumu) şeklinde olurlar. 36 yaşında bir ev hanımı hasta acil servise akut intestinal tıkanıklık bulguları ile başvurdu. Detaylı hikaye ve fizik muayene yapıldı. Preoperatif periyotta hastadan hurma yeme hikayesi alındı. Abdominal ultrasonu takiben hastaya bezoar şüphesi ile laparatomi yapıldı. Enterotomi ile jejunumdaki bezoar dışarı alındı. Diospirobezoar varlığı nadirdir ve intestinal bezoar midedeki bezoar yokluğunda daha nadirdir

Anahtar Kelimeler

Diospirobezoar, jejunum, intestinal tıkanıklık, hurma

Kaynakça

• Zamir D, Goldblum C, Linova L, Polychuck I, Reitblat T, Yoffe B. Phytobezoars and trichobezoars: a 10-year experience. J Clin Gastroenterol. 38:873-6, 2004.
• Sharma RD, Chintamani, Bhatnagar D. Trichobezoar obstructing the terminal ileum. Trop Doct, 32:99-100, 2002.
• Charles AH, Jeffrey PL. Bezoars: Classification, Pathophysiology, and Treatment. Am J Gastroenterol, 83:476-478, 1988.
• Rouskova B, Kalousova J, Vyhnanek M, Szitanyi P. Trichobezoar-Rapunzel syndrome--case report. Rozhl Chir. 83:460-2, 2004.
• Doski JJ, Priebe CJ Jr, Smith T, et al. Duodenal trichobezoar caused by compression of the superior mesenteric artery. J Pediatr Surg, 30:1598-9, 1995.
• Santiago Sanchez CA, Garau Diaz P, Lugo Vicente HL: Trichobezoar in a 11 y-year old girl: A case report. Bol Asoc Med PR, 88:8-11, 1996.
• Escamilla C, Robles-Campos R, Parrilla- Paricio P: Intestinal obstruction and bezoars. J Am Coll Surg, 179:285-8, 1994.
• Mehmet Yasar, Arif Aslaner, Ahmet Zengin, Ertugrul Ertas: Kehr Sign with Gastric Bezoar: A Rare Case Report. The Internet Journal of Surgery. 6 (2): 2005.
• Schoeffl V, Varatorn R, Blinnikov O, Vidamaly V. Intestinal obstruction due to phytobezoars of banana seeds: a case report. Asian J Surg. 27:348-51, 2004.
• Zissin R, Osadchy A, Gutman V, Rathaus V, Shapiro-Feinberg M, Gayer G. CT findings in patients with small bowel obstruction due to phytobezoar. Emerg Radiol. 10:197-200, 2004.
• Duncan ND, Altken R, Venugopal S, et al. The Rapunzel syndrome. Report of a case and review of literature. West Indian Med J 1994, 43:63-5.
• De Bakey M, Oschner A. Bezoars and concretions: comprehensive review of literature, with analysis of 303 collected cases and presentation of eight additional cases. Surgery, 5:132-160, 1939.
• Nelson RS. Nonoperative management of persimmon bezoar. A successful modification of traditional papain therapy. Am J Gastroenterol. 74:264-61980.