Laparoscopic-assisted management of small bowel obstruction due to phytobezoar.
Laparoscopy is gaining increasing acceptance for diagnosis and treatment of selected cases of small bowel obstruction. We describe a laparoscopic-assisted procedure used for the treatment of small bowel obstruction caused by a bezoar. A 51-year-old man presented with acute small intestinal obstruction. He had no history of previous abdominal surgery. Diagnostic laparoscopy confirmed a distal ileal obstruction due to an enterolith (bezoar). A limited abdominal incision allowed enterotomy and removal of the obstructing bezoar. Gastroscopy performed a month later showed gastric bezoars which could not be removed endoscopically. Instead, cellulase, a hydrolytic enzyme, was used successfully to treat the condition.
Ganpathi
Iyer Shridhar
IS
Department of Surgery, National University Hospital, Singapore 119074. surv25@nus.edu.sg
Cheah
Wei-Keat
WK
D001630:Bezoars / Q000150:complications / Q000473:pathology / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D007421:Intestine, Small / Q000473:pathology / Q000601:surgery; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged