# Simultaneous gastric outlet and small bowel obstruction due to phytobezoar: a rare case report

## TL;DR

A rare case of simultaneous gastric and small bowel obstruction caused by phytobezoars is reported in a 78-year-old woman.

## Contribution

This case report highlights the diagnostic challenge of phytobezoars and their potential to cause dual obstructions.

## Key findings

- A 78-year-old woman presented with gastric outlet and small bowel obstruction due to two phytobezoars.
- The patient recovered after surgical removal of the bezoars and was discharged on postoperative day 6.

## Abstract

Small bowel obstruction is a common surgical problem with a wide variety of causes, although bezoars are a rare etiology. Among them, phytobezoars, composed of undigested vegetable or fruit fibers, are the most frequent type. Their clinical presentation often mimics more common causes of intestinal obstruction, making accurate diagnosis challenging. We report the case of a 78-year-old woman who presented with an 8-day history of abdominal pain, nausea, and vomiting. Imaging revealed both gastric outlet and small bowel obstruction. At laparotomy, two phytobezoars were identified and successfully removed from the stomach and ileum. The patient recovered well and was discharged on postoperative day 6. This case highlights the importance of considering bezoars as a differential diagnosis in intestinal obstruction, as management may be surgical or conservative depending on the circumstances.