Abstract
We report a case of a 79 year old man with a known benign anastomotic stricture presenting with large bowel obstruction. At laparotomy the obstruction was found to be caused by a large sesame seed bezoar. Seed bezoars are well known to cause impaction in the rectum but have never been previously reported to cause large bowel obstruction. We recommend that patients with known large bowel strictures should be advised not to eat seeds as this could ultimately lead to obstruction, ischaemia or perforation.
Highlights
A bezoar is a mass of swallowed foreign indigestible material found within the gastrointestinal tract
Barium enema demonstrated a stricture in the sigmoid colon and computerised tomography revealed an inflammatory mass in the sigmoid colon with communication into the bladder
Seed bezoars in the rectum have been considered an uncommon cause of faecal impaction in adults
Summary
A bezoar is a mass of swallowed foreign indigestible material found within the gastrointestinal tract They have been known to occur in animals and man for centuries. Classification depends on content – phytobezoars (plant fibres), trichobezoars (hair), and lactobezoars (milk curds) They may occur in combinations like trichophytobezoars, and can result from virtually anything capable of forming concretions within the gastrointestinal tract, including medications [1]. Barium enema demonstrated a stricture in the sigmoid colon and computerised tomography revealed an inflammatory mass in the sigmoid colon with communication into the bladder. He underwent a sigmoid colectomy, with histology showing diverticular disease. The gentleman has made an uneventful recovery and on further questioning he recalls regularly eating nuts and seeds as part of his healthy diet
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