title: An unusual cause of small bowel obstruction in a child: ingested rhubarb.
abstract: Small bowel obstruction is rarely caused by bezoars concretions formed from undigested foreign material in the gastrointestinal tract. An important cause of bezoars is phytobezoars, formed from vegetables or fruits. A four-year-old boy presented to our emergency department with symptoms of acute intestinal obstruction. Upright plain abdominal radiography revealed multiple air fluid levels. Ultrasound showed no abnormalities, and because of worsening symptoms computed tomography of abdomen was performed. It showed intraluminal obstruction of the terminal ileum. Exploratory laparotomy revealed a phytobezoar consisting of undigested rhubarb. The mass was milked through the large bowel and out the anus. Although rare in humans, bezoars are a well-documented cause of small bowel obstruction and should be considered when intraluminal bowel obstruction occurs. Bezoars causing small bowel obstruction may require surgical treatment.
authors.affiliation: Division of Pediatric Emergency Medicine, Department of Pediatrics, Dana-Dwek Children's Hospital, Tel-Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel-Aviv University, 6 Weizman Street, 64239 Tel-Aviv, Israel ; Division of Clinical Pharmacology and Toxicology, Ichilov Hospital, Dana-Dwek Children's Hospital, Tel-Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel-Aviv University, 6 Weizman Street, 64239 Tel-Aviv, Israel.
authors.forename: Miguel
authors.initials: M
authors.lastname: Glatstein
authors.forename: Dana
authors.initials: D
authors.lastname: Danino
authors.forename: Ayelet
authors.initials: A
authors.lastname: Rimon
authors.forename: Sergei
authors.initials: S
authors.lastname: Keidar
authors.forename: Dennis
authors.initials: D
authors.lastname: Scolnik