title: Phytobezoar leading to gastric outlet obstruction in a patient with diabetes.
abstract: Gastroparesis is a condition which results in delayed gastric emptying without gastric outflow tract obstruction. Gastrointestinal involvement in diabetes can present in various forms such as oesophageal dysmotility, gastro-oesophageal reflux disease, gastroparesis, enteropathy, non-alcoholic fatty liver disease and glycogenic hepatopathy. Gastroparesis is the most common gastric motility disorder complicating long-standing diabetes. It can sometimes lead to mechanical obstruction as a result of formation of bezoars. Phytobezoars are the most common type of bezoar and are composed of indigestible food, vegetable fibre or seeds. Poor pyloric function and decreased acid formation predisposes phytobezoars formation in patients with diabetic gastroparesis. An 80-year-old patient with diabetes in our presentation developed gastric outlet obstruction due to impaction of phytobezoar over the pylorus.
authors.affiliation: Department of Medicine, Sikkim Manipal Institute of Medical Science, Gangtok, Sikkim, India.
authors.forename: Om Prakash
authors.initials: OP
authors.lastname: Dhakal
authors.affiliation: Department of Medicine, Sikkim Manipal Institute of Medical Science, Gangtok, Sikkim, India.
authors.forename: Mona
authors.initials: M
authors.lastname: Dhakal
authors.affiliation: Department of Microbiology, Sikkim Manipal Institute of Medical Sciences and Central Referral Hospital, Gangtok, Sikkim, India.
authors.forename: Dhurba
authors.initials: D
authors.lastname: Bhandari
mesh_terms: D000369:Aged, 80 and over; D001630:Bezoars / Q000150:complications* / Q000601:surgery; D048909:Diabetes Complications / Q000150:complications* / Q000601:surgery; D017219:Gastric Outlet Obstruction / Q000209:etiology* / Q000601:surgery; D018589:Gastroparesis / Q000209:etiology* / Q000601:surgery; D005773:Gastroscopy; D006801:Humans; D008297:Male