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Small bowel obstruction caused by dried apple

INTRODUCTION: Small bowel obstruction in a virgin abdomen is an uncommon surgical condition. While malignancy, inflammatory bowel disease and foreign body are the main reported causes, undigested food bezoar causing bowel obstruction is a rare entity. We report a case of small bowel obstruction seco...

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Autores principales: Ooi, Sally, Hong, Khiem
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4430109/
https://www.ncbi.nlm.nih.gov/pubmed/25841159
http://dx.doi.org/10.1016/j.ijscr.2015.03.038
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author Ooi, Sally
Hong, Khiem
author_facet Ooi, Sally
Hong, Khiem
author_sort Ooi, Sally
collection PubMed
description INTRODUCTION: Small bowel obstruction in a virgin abdomen is an uncommon surgical condition. While malignancy, inflammatory bowel disease and foreign body are the main reported causes, undigested food bezoar causing bowel obstruction is a rare entity. We report a case of small bowel obstruction secondary to dried preserved apple having re-expanded within the gastrointestinal tract. PRESENTATION OF CASE: A 69 year old male presented with severe abdominal distension, generalized abdominal tenderness and obstipation for 1 week. Small bowel obstruction (SBO) was confirmed on plain abdominal X-ray and CT imaging. An emergency explorative laparatomy identified a sausage-shaped intra-luminal foreign body obstructing the distal ileum. An enterotomy was performed which revealed a rehydrated, donut-shaped piece of dried apple. DISCUSSION: Swallowed items that pass through the pylorus rarely cause obstruction as they are usually small enough to pass through the rest of the bowel without difficulty. We postulate that in our patient that the dried apple was originally small enough to pass through the pylorus. However during small bowel, its’ highly absorbable nature resulted in an increase in size that prevented its’ passage through the ileocecal valve. A simple in-vitro experiment discovered that dried apple has a potential to reabsorb fluid and expand up to 35% of its initial size within 72 h. CONCLUSION: This report illustrates the potential for dried food substances to cause intra-luminal SBO after significant expansion with rehydration.
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spelling pubmed-44301092015-05-15 Small bowel obstruction caused by dried apple Ooi, Sally Hong, Khiem Int J Surg Case Rep Case Report INTRODUCTION: Small bowel obstruction in a virgin abdomen is an uncommon surgical condition. While malignancy, inflammatory bowel disease and foreign body are the main reported causes, undigested food bezoar causing bowel obstruction is a rare entity. We report a case of small bowel obstruction secondary to dried preserved apple having re-expanded within the gastrointestinal tract. PRESENTATION OF CASE: A 69 year old male presented with severe abdominal distension, generalized abdominal tenderness and obstipation for 1 week. Small bowel obstruction (SBO) was confirmed on plain abdominal X-ray and CT imaging. An emergency explorative laparatomy identified a sausage-shaped intra-luminal foreign body obstructing the distal ileum. An enterotomy was performed which revealed a rehydrated, donut-shaped piece of dried apple. DISCUSSION: Swallowed items that pass through the pylorus rarely cause obstruction as they are usually small enough to pass through the rest of the bowel without difficulty. We postulate that in our patient that the dried apple was originally small enough to pass through the pylorus. However during small bowel, its’ highly absorbable nature resulted in an increase in size that prevented its’ passage through the ileocecal valve. A simple in-vitro experiment discovered that dried apple has a potential to reabsorb fluid and expand up to 35% of its initial size within 72 h. CONCLUSION: This report illustrates the potential for dried food substances to cause intra-luminal SBO after significant expansion with rehydration. Elsevier 2015-03-25 /pmc/articles/PMC4430109/ /pubmed/25841159 http://dx.doi.org/10.1016/j.ijscr.2015.03.038 Text en © 2015 The Authors http://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
Ooi, Sally
Hong, Khiem
Small bowel obstruction caused by dried apple
title Small bowel obstruction caused by dried apple
title_full Small bowel obstruction caused by dried apple
title_fullStr Small bowel obstruction caused by dried apple
title_full_unstemmed Small bowel obstruction caused by dried apple
title_short Small bowel obstruction caused by dried apple
title_sort small bowel obstruction caused by dried apple
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4430109/
https://www.ncbi.nlm.nih.gov/pubmed/25841159
http://dx.doi.org/10.1016/j.ijscr.2015.03.038
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