Obstructing small bowel bezoars due to an agar diet: diagnosis using double balloon enteroscopy

Successful treatment of small bowel phytobezoar using double balloon enterolithotripsy combined with sequential catharsis: A case report

BACKGROUND

Small bowel bezoar obstruction (SBBO) is a rare clinical condition characterized by hard fecal masses in the small intestine, causing intestinal obstruction. It occurs more frequently in the elderly and bedridden patients, but can also affect those with specific gastrointestinal dysfunctions. Diagnosing SBBO is challenging due to its clinical presentation, which mimics other intestinal obstructions. While surgical intervention is the typical treatment for SBBO, advancements in endoscopic techniques have led to increased use of non-surgical methods, such as endoscopic lithotripsy.

CASE SUMMARY

We report a case of small bowel obstruction induced by a phytobezoar. A 49-year-old male with a history of type 2 diabetes and long-term persimmon consumption presented to the hospital with symptoms of vomiting, abdominal distension, and constipation. Computed tomography revealed a small bowel obstruction with foreign bodies. Double balloon enteroscopy identified a phytobezoar blocking the intestinal lumen. The bezoar was successfully fragmented using a snare, and the fragments were treated with 100 mL of paraffin oil to facilitate their passage. This case report aims to enhance the understanding of this rare condition by detailing the clinical presentation, diagnostic process, and treatment outcomes of a patient with SBBO. Special attention is given to the application and effectiveness of non-surgical treatment methods, along with strategies to optimize patient management.

CONCLUSION

Double balloon enteroscopy combined with sequential laxative therapy is an effective approach for the treatment of a breakable phytobezoar.

An Unusual Small Bowel Phytobezoar Successfully Resolved by Double-balloon Enteroscopy

We herein report a very unusual case of small bowel obstruction caused by phytobezoar in a 69-year-old woman who consumed a large amount of bracken. The patient presented with nausea and vomiting. Computed tomography revealed an air-filled foreign body in the jejunum that had likely caused the small bowel obstruction. A fibrous foreign body diagnosed as a phytobezoar was detected using double-balloon enteroscopy. The obstruction was successfully resolved by crushing the phytobezoar repeatedly using a snare. Small bowel obstructions caused by phytobezoars are often treated with surgical interventions. However, endoscopic fragmentation using a snare is a minimally invasive treatment alternative.

Seaweed's Bioactive Candidate Compounds to Food Industry and Global Food Security

The world population is continuously growing, so it is important to keep producing food in a sustainable way, especially in a way that is nutritious and in a sufficient quantity to overcome global needs. Seaweed grows, and can be cultivated, in seawater and generally does not compete for arable land and freshwater. Thus, the coastal areas of the planet are the most suitable for seaweed production, which can be an alternative to traditional agriculture and can thus contribute to a reduced carbon footprint. There are evolving studies that characterize seaweed's nutritional value and policies that recognize them as food, and identify the potential benefits and negative factors that may be produced or accumulated by seaweed, which are, or can be, dangerous for human health. Seaweeds have a high nutritional value along with a low caloric input and with the presence of fibers, proteins, omega 3 and 6 unsaturated fatty acids, vitamins, and minerals. Moreover, several seaweed sub-products have interesting features to the food industry. Therefore, the focus of this review is in the performance of seaweed as a potential alternative and as a safe food source. Here described is the nutritional value and concerns relating to seaweed consumption, and also how seaweed-derived compounds are already commercially explored and available in the food industry and the usage restrictions to safeguard them as safe food additives for human consumption.

A case of small bowel obstruction caused by bezoars diagnosed with double balloon enteroscopy

Primary small bowel bezoars are rare and cause acute abdomen due to small bowel obstruction (SBO). A 69-year-old Japanese man presented with epigastric pain associated with fullness. Physical examination of the abdomen showed no marked signs of peritoneal irritation. An erect X-ray film of the abdomen showed small bowel obstruction. Computed tomography (CT) showed a dilated small bowel loop proximal to the site of the obstruction. Retrograde double balloon enteroscopy (DBE) was performed and showed yellow, hard bezoars blocking the distal ileum. At surgery, a bezoar was found impacted in the distal ileum, and enterotomy with extraction was performed. After 9 days, the patient was discharged from our hospital in satisfactory condition. DBE also appears to be a safe and useful diagnostic tool in patients with SBO, and the findings of DBE influence the strategy of therapy in patients in whom the cause of SBO could not be determined by conventional radiography.