# Small Bowel Obstruction Caused by a Bezoar in a Duodenal Diverticulum

## TL;DR

A rare case of small bowel obstruction caused by a bezoar in a duodenal diverticulum is reported, highlighting the need for surgical intervention when non-operative management fails.

## Contribution

This paper presents a rare clinical case of small bowel obstruction due to a bezoar in a duodenal diverticulum.

## Key findings

- A 60-year-old patient had a bezoar in a duodenal diverticulum causing small bowel obstruction.
- Non-operative management failed, requiring surgical removal of the bezoar.
- Such complications are rare but should be considered in patients with large duodenal diverticula.

## Abstract

Duodenal diverticula are often found incidentally. Similarly to colonic diverticula, though much less common, duodenal diverticula can cause complications including perforation, fistulas, and abscesses. This report describes a rare complication of small bowel obstruction secondary to a bezoar formed within a duodenal diverticulum.

This 60-year-old patient presented to the ED with abdominal pain. CT imaging demonstrated a duodenal diverticulum arising from the distal portion of the duodenum (D3/D4), distal to the ampulla. She was initially managed non-operatively with bowel rest; however, on repeat CT imaging with oral contrast, she was found to have a small bowel obstruction secondary to a bezoar. She ultimately was taken to the operating room for a small bowel enterotomy and removal of the bezoar.

Small bowel obstruction caused by a bezoar is a rare complication of large duodenal diverticula. While initial non-operative management is appropriate, surgical intervention should be considered in patients who fail to improve.