Multiple small bowel obstructions due to unusual formation of biliary phytobezoars following laparoscopic cholecystectomy in a sickler patient: A case report, an atypical surgical approach

INTRODUCTION & IMPORTANCE: Bezoar formation in gastrointestinal tract is relatively a rare condition. A phytobezoar is the most common type of bezoar (Kement et al., 2012 [6]). Biliary phytobezoar is an extremely rare condition and is usually reported in patients had previous biliary procedures...

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Autor principal: Al-Abbadi, Hatim Ali
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10661604/
https://www.ncbi.nlm.nih.gov/pubmed/37956495
http://dx.doi.org/10.1016/j.ijscr.2023.109013
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author Al-Abbadi, Hatim Ali
author_facet Al-Abbadi, Hatim Ali
author_sort Al-Abbadi, Hatim Ali
collection PubMed
description INTRODUCTION & IMPORTANCE: Bezoar formation in gastrointestinal tract is relatively a rare condition. A phytobezoar is the most common type of bezoar (Kement et al., 2012 [6]). Biliary phytobezoar is an extremely rare condition and is usually reported in patients had previous biliary procedures or in presence of bilioenteric fistula (Albogami et al., 2018; Kement et al., 2012; Kim et al., 2006 [2, 6, 7]). CASE PRESENTATION: 35-year-old female with sickle cell anemia (SCA). On 2003 she had gallstones (GS) and obstructive jaundice. She was treated at that time by endoscopic retrograde cholangiopancreatography (ERCP) and sphincterotomy with stent insertion, followed by laparoscopic cholecystectomy (LC). Two years afterwards she had open appendectomy for acute appendicitis. Six months afterward, she suffered several episodes of small bowel obstructions (SBO) for several years. Later, it was discovered due to unusual formation of primary gallstones and subsequent development of biliary phytobezoars accumulated in the terminal ileum causing SBO. CLINICAL DISCUSSION: We are presenting an extremely rare case who developed biliary phytobezoars formation in the absence of a bilioenteric fistula leading to multiple small bowel obstructions. The origin of the gallstones was primary type. The surgical approach was limited right hemicolectomy solved her problem completely until the date of this publication. CONCLUSION: The nature of the disease adding higher risk of morbidity. Management of sicklers with surgical conditions should be individualized. Sicklers with asymptomatic gallstones should have early LC before complications begin. Because anticipated complications carry significant morbidity. The advances in surgical technology and better awareness of the pathophysiology provided an improved and better outcome.
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spelling pubmed-106616042023-11-10 Multiple small bowel obstructions due to unusual formation of biliary phytobezoars following laparoscopic cholecystectomy in a sickler patient: A case report, an atypical surgical approach Al-Abbadi, Hatim Ali Int J Surg Case Rep Case Report INTRODUCTION & IMPORTANCE: Bezoar formation in gastrointestinal tract is relatively a rare condition. A phytobezoar is the most common type of bezoar (Kement et al., 2012 [6]). Biliary phytobezoar is an extremely rare condition and is usually reported in patients had previous biliary procedures or in presence of bilioenteric fistula (Albogami et al., 2018; Kement et al., 2012; Kim et al., 2006 [2, 6, 7]). CASE PRESENTATION: 35-year-old female with sickle cell anemia (SCA). On 2003 she had gallstones (GS) and obstructive jaundice. She was treated at that time by endoscopic retrograde cholangiopancreatography (ERCP) and sphincterotomy with stent insertion, followed by laparoscopic cholecystectomy (LC). Two years afterwards she had open appendectomy for acute appendicitis. Six months afterward, she suffered several episodes of small bowel obstructions (SBO) for several years. Later, it was discovered due to unusual formation of primary gallstones and subsequent development of biliary phytobezoars accumulated in the terminal ileum causing SBO. CLINICAL DISCUSSION: We are presenting an extremely rare case who developed biliary phytobezoars formation in the absence of a bilioenteric fistula leading to multiple small bowel obstructions. The origin of the gallstones was primary type. The surgical approach was limited right hemicolectomy solved her problem completely until the date of this publication. CONCLUSION: The nature of the disease adding higher risk of morbidity. Management of sicklers with surgical conditions should be individualized. Sicklers with asymptomatic gallstones should have early LC before complications begin. Because anticipated complications carry significant morbidity. The advances in surgical technology and better awareness of the pathophysiology provided an improved and better outcome. Elsevier 2023-11-10 /pmc/articles/PMC10661604/ /pubmed/37956495 http://dx.doi.org/10.1016/j.ijscr.2023.109013 Text en © 2023 The Author. Published by Elsevier Ltd on behalf of IJS Publishing Group Ltd. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
Al-Abbadi, Hatim Ali
Multiple small bowel obstructions due to unusual formation of biliary phytobezoars following laparoscopic cholecystectomy in a sickler patient: A case report, an atypical surgical approach
title Multiple small bowel obstructions due to unusual formation of biliary phytobezoars following laparoscopic cholecystectomy in a sickler patient: A case report, an atypical surgical approach
title_full Multiple small bowel obstructions due to unusual formation of biliary phytobezoars following laparoscopic cholecystectomy in a sickler patient: A case report, an atypical surgical approach
title_fullStr Multiple small bowel obstructions due to unusual formation of biliary phytobezoars following laparoscopic cholecystectomy in a sickler patient: A case report, an atypical surgical approach
title_full_unstemmed Multiple small bowel obstructions due to unusual formation of biliary phytobezoars following laparoscopic cholecystectomy in a sickler patient: A case report, an atypical surgical approach
title_short Multiple small bowel obstructions due to unusual formation of biliary phytobezoars following laparoscopic cholecystectomy in a sickler patient: A case report, an atypical surgical approach
title_sort multiple small bowel obstructions due to unusual formation of biliary phytobezoars following laparoscopic cholecystectomy in a sickler patient: a case report, an atypical surgical approach
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10661604/
https://www.ncbi.nlm.nih.gov/pubmed/37956495
http://dx.doi.org/10.1016/j.ijscr.2023.109013
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