Small Bowel Obstruction Produced by a Phytobezoar

Abstract

A 68-year-old man was admitted to the hospital with a history of daily vomiting and weight loss of 8 kg within 3 weeks. The patient had undergone a selective proximal vagotomy with pyloroplasty for a bleeding duodenal ulcer (1981) and a Billroth I reconstruction with distal gastrectomy for a perforated NSAID-induced gastric ulcer (1999). Laboratory data revealed leukocytosis of 15,400/mm3 (range, 4,200–10,200), with 88% neutrophils (range, 42%–69%) and a modest increase of the C- reactive protein, 7 mg/L (range, <5).