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Khirurgii

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Year 2023 Vol. 31 No 3

SCIENTIFIC PUBLICATIONS

M.D. ROMANOV 1, E.M. KIREEVA 1, 2

PECULIARITIES OF BEZOAR-INDUCED SMALL BOWEL OBSTRUCTION

National Research Mordovia State University 1,
Republican Clinical Hospital No 4 2, Saransk,
Russian Federation

The article presents a clinical observation of a rare pathology – acute intestinal obstruction caused by phytobezoar of the ileum, in the debut of which signs of acute pancreatitis prevailed. Four percent of small bowel obstructions are caused by bezoars, which can be formed due to large fiber intake, inadequate mastication, hasty swallowing, reduced gastric motility and pyloric dysfunction. The causes of bezoar retention in the ileum could be anatomical and functional differences of the small intestine (smaller lumen of the ileum, presence of ileocecal valve, which prevents premature progression of the contents into the colon, less mobility due to shorter mesentery, increased intensity of water absorption compared to the jejunum), as well as adhesions in the right iliac fossa. The unusual debut of small intestinal obstruction could be due to the slow progress of bezoar from the jejunum to the ileum due to a violation of the motor evacuation function of the digestive tract against the background of gastritis and exacerbation of chronic pancreatitis. The obstruction was treated by manual fragmentation of the bezoar and its relegation to the colon during laparotomy and subsequent conservative therapy.

Keywords: ileum bezoar, obturator small intestinal obstruction, clinical observation, diagnostic and therapeutic tactics
p. 231-239 of the original issue
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Address for correspondence:
430032, Russian Federation,
Saransk, Ulyanov st., 32,
Mordovian State University
named after. N.P. Ogarev,
Department of Hospital Surgery,
tel.: +79279710237,
e-mail: mdromanov@yandex.ru,
Romanov Mikhail Dmitrievich
Information about the authors:
Romanov Mikhail D., MD, Professor, Professor of the Department of Hospital Surgery of National Research Mordovian State University named after. N.P. Ogarev, Saransk, Russian Federation.
https://orcid.org/0000-0002-9646-4007
Kireeva Ekaterina M., PhD. Associate Professor, Associate Professor, Department of Hospital Surgery of National Research Mordovian State University named after. N.P. Ogarev; Surgeon, Republican Clinical Hospital No4, Saransk, Russian Federation.
https://orcid.org/0000-0003-1034-167X
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