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World J Gastroenterol. Jan 7, 2013; 19(1): 133-136
Published online Jan 7, 2013. doi: 10.3748/wjg.v19.i1.133
Published online Jan 7, 2013. doi: 10.3748/wjg.v19.i1.133
Biliary phytobezoar resulting in intestinal obstruction
Yura Kim, Beom Jin Park, Min Ju Kim, Deuk Jae Sung, Department of Radiology, College of Medicine, Korea University, Anam Hospital, Seoul 136-705, South Korea
Dong-Sik Kim, Young-Dong Yu, Division of HBP Surgery and Liver Transplantation, Department of Surgery, College of Medicine, Korea University, Anam Hospital, Seoul 136-705, South Korea
Jeong Hyeon Lee, Department of Pathology, College of Medicine, Korea University, Anam Hospital, Seoul 136-705, South Korea
Author contributions: Kim Y and Park BJ interpreted the data and wrote the manuscript; Kim MJ and Sung DJ reviewed the literature and edited the manuscript; Kim DS and Yu YD contributed to revision of the surgical and scientific parts of the manuscript; Lee JH contributed to revisions of the pathology portions of the manuscript.
Correspondence to: Beom Jin Park, MD, PhD, Department of Radiology, College of Medicine, Korea University, Anam Hospital, 126-1, 5-Ka, Anam Dong, Sung buk-ku, Seoul 136-705, South Korea. rupture226@hanmail.net
Telephone: +82-2-9205578 Fax: +82-2-9203796
Received: September 9, 2012
Revised: September 20, 2012
Accepted: September 28, 2012
Published online: January 7, 2013
Revised: September 20, 2012
Accepted: September 28, 2012
Published online: January 7, 2013
Abstract
Phytobezoar is the most common type of bezoar. It is composed of indigestible vegetable matter and is usually found in the stomach. Biliary phytobezoar is extremely rare and difficult to diagnose preoperatively. The pathogenesis is not clear, and there have been only a few reports of biliary bezoars associated with sphincteric impairmentat the ampulla of Vater. Here, we present a report of biliary bezoar that resulted in jejunal obstruction. We were unable to identifythe bezoar in the extrahepatic bile duct until it obstructed the small bowel lumen. To our knowledge, this is the first report of small bowel obstruction resulting frommigration of a biliary bezoar.
Keywords: Phytobezoar, Biliary, Intestinal obstruction, Choledochoduodenal, Fistula, Multidetector-row computed tomography