A rare case of acute large bowel obstruction due to colonic bezoars associated with pica in a pediatric patient: A case report.
| Autor: | Sah P; Department of Pediatric Surgery, Kanti Children Hospital, Kathmandu, Nepal., Gyawali S; Department of Pediatric Surgery, Kanti Children Hospital, Kathmandu, Nepal. Electronic address: drsushilgyawali@gmail.com., Joshi MP; Department of Pediatric Surgery, Kanti Children Hospital, Kathmandu, Nepal., Kayastha A; Department of Pediatric Surgery, Kanti Children Hospital, Kathmandu, Nepal., Rajkarnikar R; Department of Pediatric Surgery, Kanti Children Hospital, Kathmandu, Nepal. |
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| Jazyk: | angličtina |
| Zdroj: | International journal of surgery case reports [Int J Surg Case Rep] 2024 Nov 25; Vol. 126, pp. 110662. Date of Electronic Publication: 2024 Nov 25. |
| DOI: | 10.1016/j.ijscr.2024.110662 |
| Abstrakt: | Introduction: Colonic bezoars are undigested or partially digested materials that accumulate in the form of a mass in the colon. There are occasional reports of constipation and intestinal obstruction due to geophagia or pica. Bezoars are due to pica, which is commonly associated with iron deficiency anemia and psychiatry disorders. Case Presentation: A nine-year old female child presented with complaint of abdominal pain, vomiting and constipation for few months, and lately with features anemia and acute intestinal obstruction. She had history of pica. After evaluation she was treated surgically in two stages. In the first stage exploratory laparotomy with evacuation of lithobezoars with transverse colostomy was done, which was followed by colostomy reversal in the second stage. As a part of multidisciplinary treatment, psychiatric counseling and nutritional support were provided. Discussion: Colonic lithobezoars presenting with features of chronic constipation and complicated with large bowel obstruction is a rare finding. Diagnostic imaging modalities such as X-ray and CT scan play an important role in confirming the diagnosis. Initial management involves conservative measures for uncomplicated cases with surgical intervention as a definitive option for complications like obstruction or perforation. Conclusion: This case highlights the importance of considering pica with bezoars in children presenting with anemia and features of bowel obstruction. In such case multidisciplinary support and definitive medical and surgical management is done. Competing Interests: Conflict of interest statement None. (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.) |
| Databáze: | MEDLINE |
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