title: Phytobezoar in a jejunal diverticulum as a cause of small bowel obstruction: a case report.
abstract: BACKGROUND
  Phytobezoars are concretions of poorly digested fruit and vegetable fibers found in the alimentary tract. Previous gastric resection, gastrojejunostomy, or pyloroplasty predispose people to bezoar formation. Small-bowel bezoars normally come from the stomach, and primary small-bowel bezoars are very rare. They are seen only in patients with underlying small-bowel diseases such as diverticula, strictures, or tumors. Primary small-bowel bezoars almost always present as intestinal obstructions, although it is a very rare cause, being responsible for less than 3% of all small-bowel obstructions in one series. Jejunal diverticula are rare, with an incidence of less than 0.5%. They are usually asymptomatic pseudodiverticula of pulsion type, and complications are reported in 10% to 30% of patients. A phytobezoar in a jejunal diverticulum is an extremely rare presentation.
  
  
  METHODS
  A 78-year-old Pakistani man presented to our clinic with small-bowel obstruction. Upon exploration, we found a primary small-bowel bezoar originating in a jejunal diverticulum and causing jejunal obstruction. Resection and anastomosis of the jejunal segment harboring the diverticulum was performed, and our patient had an uneventful recovery.
  
  
  CONCLUSIONS
  Primary small-bowel bezoars are very rare but must be kept in mind as a possible cause of small-bowel obstruction.
authors.affiliation: Department of Surgery, Peshawar Medical College, Peshawar Medical College Warsak Road, Peshawar KPK, Pakistan. drmtayeb@yahoo.com.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Tayeb
authors.forename: Faiz Mohammad
authors.initials: FM
authors.lastname: Khan
authors.forename: Fozia
authors.initials: F
authors.lastname: Rauf
authors.forename: M Mumtaz
authors.initials: MM
authors.lastname: Khan