An Unusual Mimic of Intermittent Bowel Obstruction

BACKGROUND: Indigestible foreign material in the bowel can develop into bezoars. Intestinal obstruction can occur secondary to these bezoars. Phytobezoars specifically refer to those which accumulate as a result of undigested plant or other food material.
CASE REPORT: A 42-year-old woman presented to the Emergency Department with a several-month history of right-sided abdominal pain associated with bouts of vomiting. She had no other significant medical history. Labs and computed tomography were unrevealing. Gastroenterology was consulted and performed endoscopy. A foreign body resembling an undigested mini bell pepper was found near the terminal ileum. This was removed, and the patient later reported significant improvement in her symptoms.
CONCLUSIONS: Phytobezoars can lead to symptoms consistent with intestinal obstruction. The underlying pathology (e.g., masses, gastritis, adhesions, or dysmotility) can precipitate obstructions in the setting of bezoar formation. Surgical removal if often necessary for small-bowel obstructions secondary to bezoars, but in our case, fortunately, the foreign body was successfully removed during endoscopy.

Keywords: Bezoars, Endoscopy, Gastroenterology, Intestinal Pseudo-Obstruction