Laparoscopic treatment of bowel obstruction due to a bezoar in a Meckel's diverticulum.
OBJECTIVE
Meckel's diverticulum is a common anomaly of the gastrointestinal tract that may result in gastrointestinal bleeding, diverticulitis, and small bowel obstruction. This report describes the use of laparoscopy to treat a rare complication of Meckel's  diverticulum-small bowel obstruction due to phytobezoar impaction. More generally, it provides an example of the feasibility and utility of a laparoscopic approach to small bowel obstructions of unknown causes.


METHODS
A 34-year-old male presented to the emergency department  complaining of episodic abdominal pain and vomiting. He had no history of abdominal surgery. His vital signs were stable, and his abdomen was distended, but only mildly tender. He had no abdominal wall hernias on examination. Imaging was consistent with small bowel obstruction. He was brought  to the operating room where laparoscopy revealed a Meckel's diverticulum with an impacted phytobezoar as the source of obstruction. The diverticulum was resected and the phytobezoar removed laparoscopically.


RESULTS
The patient recovered well and was discharged home on the third  postoperative day, tolerating a regular diet.


CONCLUSIONS
Phytobezoar impaction in a Meckel's diverticulum causing small bowel obstruction is a rare event. It can be effectively treated laparoscopically. This case provides an example of the potential utility of laparoscopy in treating  small bowel obstructions of unclear etiology.
Department of Surgery, Massachusetts General Hospital, Boston, MA, USA. pfagenholz@partners.org
Peter J
PJ
Fagenholz
Marc A
MA
de Moya
D000328:Adult; D001630:Bezoars / Q000150:complications* / Q000175:diagnosis / Q000601:surgery*; D003937:Diagnosis, Differential; D006801:Humans; D007415:Intestinal Obstruction / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery*; D007421:Intestine, Small; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008467:Meckel Diverticulum / Q000150:complications* / Q000175:diagnosis / Q000601:surgery*; D014057:Tomography, X-Ray Computed