title: Acute surgical abdomen due to phytobezoar-induced ileal obstruction.
abstract: BACKGROUND
  Phytobezoar-induced small bowel obstruction is an uncommon clinical entity accounting for 2-4.8% of all mechanical intestinal obstructions. In addition, presentation with features of acute surgical abdomen is extremely rare, accounting for only 1% of the patients.
  
  
  OBJECTIVE
  The aim of this report is to present a very rare case of a phytobezoar-induced small bowel obstruction in a male patient who presented with acute surgical abdomen. A correct preoperative diagnosis was made based on the patient's history and characteristic imaging features on the emergency computed tomography (CT) scan.
  
  
  METHODS
  A 55-year-old man with previous gastrectomy presented with typical manifestations of acute abdomen. CT scan demonstrated dilatated small bowel loops and an intraluminal ileal mass with a mottled appearance. At exploratory laparotomy, a phytobezoar was found impacted in the terminal ileum and was removed through an enterotomy.
  
  
  CONCLUSIONS
  Phytobezoar should be considered in patients with previous gastric outlet surgery who present with bowel obstruction and features of acute surgical abdomen. The presence of a well-defined intraluminal mass with a mottled gas pattern on emergency CT scan is suggestive of an intestinal phytobezoar.
authors: Second Department of Surgery, Army General Hospital, Athens, Greece.
authors: Nikolaos S
authors: NS
authors: Salemis
authors: Nikolaos
authors: N
authors: Panagiotopoulos
authors: Nikolaos
authors: N
authors: Sdoukos
authors: Evangelos
authors: E
authors: Niakas
mesh_terms: D000006:Abdomen, Acute / Q000209:etiology*; D001630:Bezoars / Q000150:complications*; D005743:Gastrectomy; D006801:Humans; D007077:Ileal Diseases / Q000150:complications / Q000209:etiology*; D007415:Intestinal Obstruction / Q000150:complications / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D014057:Tomography, X-Ray Computed