Meat Bolus Bezoar Leading To Small Bowel Obstruction: A Case Report

Abstract

Introduction: Foreign body ingestion and food bolus impaction are common causes of emergency interventions. Among them, bezoars, indigestible materials accumulated in the gastrointestinal tract, constitute a rare but significant etiology of small bowel obstruction.Case Report: We present a case of a 71-year-old male with a history of gastrojejunostomy for gastric outlet obstruction due to peptic ulcer disease, admitted with abdominal distension, vomiting, and constipation. Imaging revealed acute small bowel obstruction with a transition point approximately 100 cm proximal to the ileocecal junction. Given the non-resolving small bowel obstruction, emergency emergency surgical exploration via exploratory laparotomy was done which suggested a foreign body lodged in the ileum. Enterotomy was done to successfully remove the foreign body which was found to be a meat bolus bezoar.Discussion: Bezoars, although uncommon, should be considered in cases of small bowel obstruction, with phytobezoars being the most frequently reported type. Contributing factors such as previous gastric surgery and poor mastication play a role in bezoar formation. Diagnosis typically involves imaging modalities like CT scans, with surgical intervention often necessary for resolution. Management options include enterotomy, particularly for proximally located bezoars, or bowel resection for complicated cases.Conclusion: This case underscores the importance of considering bezoars as a differential diagnosis in small bowel obstruction, particularly in patients with predisposing factors such as previous gastric surgery. Early recognition and appropriate surgical management are crucial for successful outcomes.