Giant phytobezoar; an unusual cause of gastric outlet obstruction: A case report with literature review

INTRODUCTION: Phytobezoar which is described as an undigested or incompletely digested food. It is an odd cause of gastric outlet obstruction (GOO). The aim of this study is to present and discuss a case of GOO caused by multiple giant bezoars. CASE REPORT: A 24-year-old female, presented with abdominal pain and vomiting (non-bilious) with negative past history. Examination and investigations revealed multiple giant bezoars requiring emergent surgical intervention. An exploratory laparotomy was conducted. Two giant bezoars were palpated in the stomach and removed through an anterior gastrotomy. DISCUSSION: Bezoars are regarded as rare benign causes of GOO. Bezoars can present with vomiting, nausea, and/or symptoms of GOO. Predisposing risk factors include delayed gastric emptying (as in case of diabetic mellitus) vagotomy, partial gastrectomy pyloroplasty, peptic ulcer disease, chronic gastritis, Crohn's disease, and carcinoma of the gastrointestinal tract. The current case had phytobezoar without any known risk factor. CONCLUSION: GOO caused by phytobezoar can occur in patients without history of previous gastric surgery or diabetes mellitus. Urgent laparotomy may be indicated. (C) 2020 The Author(s). Published by Elsevier Ltd on behalf of IJS Publishing Group Ltd.