Small Bowel Obstruction Secondary to a Metamucil Bezoar: Case Report and Review of the Literature
Bezoar-induced small bowel obstruction is a rare entity. It should be highly suspected in patients with gastric hypomotility disorders, psychiatric conditions, prior abdominal or bariatric surgery, or improper intake of medication. Their diagnosis is quite challenging and surgical exploration remain...
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| Language: | English |
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Wiley
2017-01-01
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| Series: | Case Reports in Surgery |
| Online Access: | http://dx.doi.org/10.1155/2017/2702896 |
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| author | Sara Abou Azar Mohammad Rachad Wehbe Sarah Jamali Ali Hallal |
| author_facet | Sara Abou Azar Mohammad Rachad Wehbe Sarah Jamali Ali Hallal |
| author_sort | Sara Abou Azar |
| collection | DOAJ |
| description | Bezoar-induced small bowel obstruction is a rare entity. It should be highly suspected in patients with gastric hypomotility disorders, psychiatric conditions, prior abdominal or bariatric surgery, or improper intake of medication. Their diagnosis is quite challenging and surgical exploration remains the best treatment of choice to ensure the viability of the small bowel tissue and relieve the obstruction. This is a case of a 48-year-old female with no previous abdominal surgery who presented with acute abdominal pain. The patient’s history was remarkable for the daily ingestion of 1.5 teaspoons of Metamucil with minimal amount of water. Computed tomography scan demonstrated dilated small bowel loops and a transition zone at the level of the mid jejunum. On laparoscopy, the patient was found to have a hard mass in the mid jejunum amenable to gentle fragmentation and breakdown. Metamucil bezoars are due to the solidification of psyllium-based substances in the gastrointestinal tract. The usual management of small bowel obstruction induced by a bezoar is exploratory laparotomy with enterotomy and primary anastomosis. Laparoscopic intervention has gained popularity among surgeons with good outcome and lower morbidity. In this unusual case, the small bowel obstruction induced by the Metamucil bezoar was safely treated with laparoscopic fragmentation alone. |
| format | Article |
| id | doaj-art-1872dedb99974bf6b8bf12230952e420 |
| institution | Kabale University |
| issn | 2090-6900 2090-6919 |
| language | English |
| publishDate | 2017-01-01 |
| publisher | Wiley |
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| series | Case Reports in Surgery |
| spelling | doaj-art-1872dedb99974bf6b8bf12230952e4202025-02-03T01:29:56ZengWileyCase Reports in Surgery2090-69002090-69192017-01-01201710.1155/2017/27028962702896Small Bowel Obstruction Secondary to a Metamucil Bezoar: Case Report and Review of the LiteratureSara Abou Azar0Mohammad Rachad Wehbe1Sarah Jamali2Ali Hallal3Department of Surgery, American University of Beirut Medical Center, Cairo Street, Riad El Solh, P.O. Box 11-0236, Beirut 1107 2020, LebanonDepartment of Surgery, American University of Beirut Medical Center, Cairo Street, Riad El Solh, P.O. Box 11-0236, Beirut 1107 2020, LebanonDepartment of Surgery, American University of Beirut Medical Center, Cairo Street, Riad El Solh, P.O. Box 11-0236, Beirut 1107 2020, LebanonDepartment of Surgery, American University of Beirut Medical Center, Cairo Street, Riad El Solh, P.O. Box 11-0236, Beirut 1107 2020, LebanonBezoar-induced small bowel obstruction is a rare entity. It should be highly suspected in patients with gastric hypomotility disorders, psychiatric conditions, prior abdominal or bariatric surgery, or improper intake of medication. Their diagnosis is quite challenging and surgical exploration remains the best treatment of choice to ensure the viability of the small bowel tissue and relieve the obstruction. This is a case of a 48-year-old female with no previous abdominal surgery who presented with acute abdominal pain. The patient’s history was remarkable for the daily ingestion of 1.5 teaspoons of Metamucil with minimal amount of water. Computed tomography scan demonstrated dilated small bowel loops and a transition zone at the level of the mid jejunum. On laparoscopy, the patient was found to have a hard mass in the mid jejunum amenable to gentle fragmentation and breakdown. Metamucil bezoars are due to the solidification of psyllium-based substances in the gastrointestinal tract. The usual management of small bowel obstruction induced by a bezoar is exploratory laparotomy with enterotomy and primary anastomosis. Laparoscopic intervention has gained popularity among surgeons with good outcome and lower morbidity. In this unusual case, the small bowel obstruction induced by the Metamucil bezoar was safely treated with laparoscopic fragmentation alone.http://dx.doi.org/10.1155/2017/2702896 |
| spellingShingle | Sara Abou Azar Mohammad Rachad Wehbe Sarah Jamali Ali Hallal Small Bowel Obstruction Secondary to a Metamucil Bezoar: Case Report and Review of the Literature Case Reports in Surgery |
| title | Small Bowel Obstruction Secondary to a Metamucil Bezoar: Case Report and Review of the Literature |
| title_full | Small Bowel Obstruction Secondary to a Metamucil Bezoar: Case Report and Review of the Literature |
| title_fullStr | Small Bowel Obstruction Secondary to a Metamucil Bezoar: Case Report and Review of the Literature |
| title_full_unstemmed | Small Bowel Obstruction Secondary to a Metamucil Bezoar: Case Report and Review of the Literature |
| title_short | Small Bowel Obstruction Secondary to a Metamucil Bezoar: Case Report and Review of the Literature |
| title_sort | small bowel obstruction secondary to a metamucil bezoar case report and review of the literature |
| url | http://dx.doi.org/10.1155/2017/2702896 |
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