Lina Lasri, Alia Yassine Kassab, Mehdi Salmane, Lina Belkouchi, Siham El Haddad, Nazik Allali, Latifa Chat
Journal: Medpeer Publisher
ISSN: 3066-2737
Volume: 3
Issue: 8
Date of Publication: 2026/08/14
Background. A bezoar is a concretion of indigestible material that accumulates within the gastrointestinal tract. Bezoar-induced small bowel obstruction is uncommon, accounting for roughly 0.4–4% of small bowel obstructions, and is exceptional in young children. We report a pediatric case and highlight its computed tomography (CT) features.
Case presentation. A previously healthy 4-year-old girl presented with a 5-day history of diffuse abdominal pain, bilious then feculent vomiting, and cessation of stool and gas. She showed clinical signs of dehydration. Laboratory work-up was normal apart from electrolyte disturbances related to dehydration and iron-deficiency anemia. Abdominal CT revealed diffuse jejuno-ileal distension with air-fluid levels, upstream of an ill-defined, heterogeneous intraluminal jejunal mass containing entrapped air bubbles (mottled gas pattern) and calcifications, consistent with an obstructing bezoar at the transition zone. After hydro-electrolyte resuscitation and nasogastric decompression, the child underwent laparotomy with removal of the obstructing mass, which was confirmed to be a phytobezoar. The postoperative course was favorable.
Conclusion. Although rare in children, a bezoar should be considered in the differential diagnosis of small bowel obstruction. CT is the key investigation, showing an intraluminal mass with a mottled gas pattern at the transition zone, allowing a preoperative diagnosis and guiding management.
bezoar; phytobezoar; small bowel obstruction; computed tomography; child
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