Presentation
Abdominal pain for 3 months with recent difficulty in defecation.
Patient Data
Dilated bowel loops with multilevel air-fluid levels are seen indicating mechanical obstruction.
A well-defined intraluminal low-density heterogeneous spongiform debris containing air bubbles is seen incarcerated at the distal ileum causing proximal bowel loop dilation due to mechanical partial obstruction.
No pneumoperitoneum is detected.
Mild intrapelvic free fluid is visible.
The mentioned findings are compatible with phytobezoar.
Case Discussion
A bezoar is a concentration of ingested material within the gastrointestinal tract. Trichobezoars (hair) and phytobezoars (poorly digested fibers, seeds, fruits) are the two most common types.
Bezoars are known to cause small bowel obstruction and sometimes CT may demonstrate the bezoar as a mass in the obstructed segment of bowel. The bezoar may be outlined by fluid in the proximally dilated small bowel, and the mass may be mottled owing to air trapped within it.
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