Bezoar, small bowel

Pitiakoudis, M., Tsaroucha, A., Constantinidis, T.C., Miraidis, K. Mid Efttathiou, E., Stathopoulos, G. A. and Simopoulos, C. (2003). Occupational exposure to wood dust. Oesophageal and small bowel obstruction by occupational bezoar report of a case. 5 International Symposium ofISSA Research Section, Abstracts, pp. 377-78. 

Small bowel obstruction due to primary small bowel bezoars was seen in a 70-year-old woman who had ingested "a large amount" of highly concentrated agar dissolved in boiling water 2 days earlier (Osada et al. 2008). 

Frohna, W.J. 1992. Metamucil bezoar An unusual cause of small bowel obstruction. Am.. Emerg. Med. 10(4) 393-395. 

Besides perforated appendicitis and intussusception, the most common causes of small howel obstruction are incarcerated hernias and adhesions. Other causes of small bowel obstruction comprise a miscellaneous group of rare conditions, such as midgut volvulus, Meckel s diverticulum, advanced stages of Crohn s disease, and bezoars. Adhesions usually result from prior surgery and are often multiple. There is an increasing tendency for initial conservative management rather than immediate operative intervention, as a proportion of cases will resolve spontaneously. 

Fig. 5.17. a Transient small bowel intussusception. The intraluminal mass with layered appearance is the small bowel, b Small bowel (jejunal) intussusception caused by a bezoar... 

The causes of bowel obstruction can be demonstrated (Ko et al. 1993a). Small bowel bezoar is usually caused by persimmons and orange, sometimes by cabbage, sauerkraut, potato peel, or grapefruit. 

Fig.4.4a,b. Phytobezoar in the jejunum, a Sonogram of upper abdomen shows hyperechoic, arc-like echo with clear acoustic shadow within a loop of the jejunum (arrows). Bowel loops proximal to the bezoar are dilated and filled with fluid, b Small bowel follow-through examination shows a large intraluminal fiUing defect at the end of the dilated jejunum, representing bezoar (arrow)... 

Tennenhouse JE,Wikon SR (1990) Sonographic detection of a small bowel bezoar. J Ultrasound Med 9 603-605... 

Gayer G, Jonas T, Apter S et al (1999) Bezoars in the stomach and small bowel - CT appearance. Clin Radiol 54 228-232... 

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