Phytobezoar of pure vegetable matter causing colonic obstruction

A non-occlusive bezoar of caecum in a 7-year-old child: ultrasound detection and multimodality imaging management

Bezoars represent the most frequent foreign bodies of gastro-intestinal system, involving first of all the stomach and small intestine; instead the cecum tract is a very uncommon site for bezoars associated with a poor abdominal symptomatology. We report a case of a very rare localization of bezoar in the caecum tract of the ascending colon in a child affected by undefined abdominal pain. In this case, the abdominal Ultrasound examination showed characteristic imaging findings of bezoar completely comparable to that of Computed Tomography, allowing an early diagnosis of bezoar and the possibility of a conservative treatment for the young patient.

Impacted foreign body in the sigmoid colon presenting as recurrent diverticulitis

We report on a patient with left-sided abdominal pain thought to be caused by recurring diverticulitis. Computed tomography of the sigmoid colon revealed diverticulosis without the presence of a foreign body. During colonoscopy, a phytobezoar in the form of a vegetable stem was discovered transversely impacted within two diverticular openings in the lumen of the sigmoid colon. A localized inflammatory reaction was present without obstruction or perforation. After endoscopic removal of the phytobezoar, the abdominal pain resolved. The patient's presumed diverticulitis was an inflammatory reaction caused by the phytobezoar. This case highlights the importance of early detection and endoscopic removal of a colonic foreign body to prevent abscess formation, fistulas, obstruction, perforation, or peritonitis. Foreign bodies masquerading as colonic diverticulitis should be considered in the absence of more common diseases.

The Yale-Affiliated Gastroenterology Program. A personal note

The Yale-Affiliated Gastroenterology Program provides an effective combination of tutorial and group dynamics and may be the model for need-based training of subspecialists in communities. If the present university centers work in partnership with quality community programs, the consequent university program may offer more pertinent education and proceed in a more appropriate direction for the field of gastroenterology than that of the currently accepted agenda.