Ileal perforation secondary to bowel obstruction caused by foreign body bezoar: A case report

• Published in: Annals of medicine and surgery 2022-10, Vol.82, Article 104564
• Main Authors: Shrestha, Nischal, Regmee, Sujan, Kharel, Abhiyan, Guragai, Mandeep
• Format: Article
• Language: English
• Subjects: Bezoars; Case Report; Case reports; Ileocecal valve; Surgical anastomosis
• ISSN: 2049-0801; 2049-0801
• DOI: 10.1016/j.amsu.2022.104564

Foreign body bezoar is a relatively uncommon variant of bezoars leading to intestinal obstruction and perforation. These are caused by the ingestion of indigestible materials that gradually grow in size. Following is the case of a young female patient with abdominal pain and distension which was associated with nausea, vomiting, and obstipation. Contrast-enhanced computed tomography of the abdomen showed dilated jejunal and ileal loops, and a tubular hypodense structure on terminal ileum. During surgery, we discovered intraluminal foreign bodies and ileal perforation proximal to the ileocecal valve. The findings were suggestive of obstruction and perforation of terminal ileum secondary to foreign body obstruction. The patient was managed successfully with ileocolic resection and anastomosis. Patients with bezoars can remain asymptomatic or present with features of bowel obstruction. These are usually discovered while performing radiological imaging for the evaluation of symptoms. Though mild to moderate cases of bezoars resolve with the treatment by chemical dissolution, surgeries should be performed in patients with foreign body bezoars and in whom complications have arose. Ingested foreign body could lead to formation of a bezoar which may cause obstruction and perforation—the sequelae must be kept in mind while managing a patient. •Foreign body bezoars are rare causes of bowel obstruction and perforation.•High index of suspicion must be kept while evaluating patients with psychiatric illnesses.•Radiology helps in identifying foreign body as the cause.•Bezoars should be considered as one of the differentials of bowel obstruction when the exact etiology is unclear.