Abstract
We herein present the case of an 83-year-old man, ASA status III, with a fragmented gastric phytobezoar causing obstruction in different parts of the gastrointestinal tract. The initial mass was obviously in the stomach, and due to continuing coughing and vomiting the bezoar was fragmented. The apex of the bezoar moved through the deformed pyloric channel, temporarily occluding first the duodenojejunal flexure and afterwards the ileus, while the larger remnants repeatedly sealed off causing gastric outlet obstruction. At emergent laparotomy, a gastrojejunostomy was created through which both bezoars were extracted, and the operation was completed with a vagotomy. The patient had an uneventful postoperative outcome and is doing well at 12-month follow-up. Complicated bezoars require emergent surgical removal.
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