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Emerg Med J. 2007 July; 24(7): 518.
PMCID: PMC2658416

Colonic phytobezoar

A healthy 51‐year‐old man presented to the emergency department owing to a lack of bowel movement and dull abdominal pain for 1 week. He had no history of any systemic illness. Physical examination disclosed hypoactive bowel sound and a 4‐cm palpable mass over the left lower quadrant. A rectal examination was normal. Unenhanced computed tomography of the abdomen and pelvis disclosed a heterogeneous intraluminal mass, measuring 4.8 cm, with a mottled gas pattern impacted at the rectal–sigmoid junction (fig 11,, arrow). Under rigid sigmoidoscopy, the bezoar was fragmented by a polypectomy snare. The follow‐up barium enema was normal and the patient made an uneventful recovery.

figure em39412.f1
Figure 1 Multidetector‐row computed tomography of the abdomen and pelvis disclosed a heterogeneous intraluminal mass, measuring 4.8 cm, with a mottled gas pattern (arrow) impacted at the rectal–sigmoid junction.

Bezoar formation often combined gastrointestinal stasis and ingestion of non‐digestible food material. The characteristic computed tomography finding of gastrointestinal bezoars is an intraluminal mass containing a mottled gas pattern.1 As 20% of patients had recurrent bezoars, avoiding causative foods as well as proper mastication and adequate water intake would probably be beneficial.

Footnotes

Competing interests: None.

References

1. Ripollés T, García‐Aguayo J, Martínez M J. et al Gastrointestinal bezoars: sonographic and CT characteristics. Am J Roentgenol 2001. 17765–69.69 [PubMed]

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