Phytobezoars as a cause of small bowel obstruction associated with a carcinoid tumor of the ileocecal area

Acta Chir Iugosl. 2003;50(2):131-3. doi: 10.2298/aci0302131p.

Abstract

Carcinoid tumors are slowly growing malignant neoplasms associated with an indolent clinical course. About 60% of such tumors are located within the gastrointestinal tract. We describe an unusual case of small bowel obstruction associated with a carcinoid tumor of the ileum. A 70-year-old woman was presented with abdominal pain, vomiting, and clinical signs of mechanical bowel obstruction. X-ray and CT-scan of the abdomen showed hydroaeric levels and the presence of intraluminal hyperdense "stones", presumably of gallbladder origin. A diagnostic laparotomy revealed that a large part of the terminal ileus was edematous, with prominent evidence of intestinal loop adhesions. The edematous part of the ileum was resected. Incision of the intestinal wall revealed a 2-cm soft mass at 8 cm from the ileocecal valve, where the presence of ten fruit pits obstructed the intestinal cavity. Histopathological examination confirmed the diagnosis of a carcinoid tumor. An interesting case of small-bowel obstruction with a double cause is presented: an ileal carcinoid and fruit pit bezoars. The pathophysiology of the obstruction is discussed.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Bezoars / complications*
  • Bezoars / diagnosis
  • Carcinoid Tumor / complications*
  • Carcinoid Tumor / diagnosis
  • Female
  • Humans
  • Ileal Neoplasms / complications*
  • Ileal Neoplasms / diagnosis
  • Ileocecal Valve*
  • Intestinal Obstruction / complications*
  • Intestinal Obstruction / diagnosis