PMC5892293_01
Computed tomography image demonstrating the small bowel obstruction secondary to the phytobezoar. A transition point is seen in the midline lower abdomen in the region of the proximal ileum, with distended proximal small bowel loops containing fecalized material and decompressed distal small bowel loops (yellow arrow). There is a similar appearance of the distended left upper quadrant bowel anastomosis site, as well as within the side-to-side small bowel anastomosis in the midabdomen. A small amount of mesenteric fluid is seen, without significant ascites, small bowel wall thickening, differential mucosal enhancement, or pneumatosis to indicate bowel compromise.
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The distended proximal small bowel loops contained fecalized material, and the distal small bowel loops were also decompressed without evidence of ascites, bowel wall enhancement, or free air (Figure 1).
Intraoperative photograph of the bezoar. A longitudinal enterotomy was performed to evacuate the phytobezoar, which measured 4 cm by 3 cm in diameter, and consisted of fibrous vegetable matter and acellular debris.
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Consequently, a longitudinal enterotomy was performed to evacuate the phytobezoar measuring 4 cm by 3 cm and was closed in a transverse fashion in two layers (Figure 2).