Small bowel obstruction due to a phytobezoar thirty years after Roux-en-Y gastrojejunostomy: A case report

INTRODUCTION: We present a case of a delayed small bowel obstruction due to a phytobezoar in a patient with a previous surgical history. PRESENTATION OF CASE: A 73-year-old male patient presented with vomiting and obstipation for a week. His past surgical history included a Roux-en-y gastrojejunostomy due to a surgical management for peptic ulcer disease 30 years ago. Abdominal computed tomography demonstrated a dilation of small bowel with air-fluid levels. He was diagnosed with acute bowel obstruction. On exploration, we found a compressible mass 150 cm from the jejunojejunostomy anastomosis. An enterotomy was performed and the mass was milked back. It was a phytobezoar. After the bezoar removal, his complaints relieved completely. DISCUSSION: Small bowel obstruction after abdominal surgery (Roux-en-y gastrojejunostomy) is a complication that may present early or late for many causes. One of the unusual underlying causes is phytobezoar. CONCLUSION: This case aims to raise awareness of phytobezoar as a cause of small bowel obstruction even in delayed presentation.