Review article
https://doi.org/10.26800/LV-145-supl4-19
Gastrointestinal obstruction with phytobezoar caused by raw food diet – case report
Nikolina Schatzl
orcid.org/0009-0001-9897-4318
; Klinika za anesteziologiju, reanimatologiju i intenzivno liječenje, Klinička bolnica “Sveti Duh”, Zagreb, Hrvatska
Višnja Nesek Adam
orcid.org/0000-0002-6521-4136
Sanja Berić
Marija Josipović
Abstract
Phytobezoar, a mass formed by the incomplete digestion of plant fibers, can be found in any part of the gastrointestinal tract. It is composed of a large amount of polymeric carbohydrates that causes obstruction in patients with predisposing factors (gastric surgery, inadequate chewing, gastroparesis). In our report, a 40-yearold patient on a raw food diet was presented to the emergency department with cramping pains in the upper abdomen and multiple episodes of vomiting for the past 2 weeks. After the initial treatment for the acute pancreatitis,
there was a worsening of colicky abdominal pain and due to the clinical signs of high ileus urgent surgical treatment was indicated. Laparotomy revealed a distended stomach and small intestine up to the level of half of the jejunum and gastrotomy revealed 2 pieces of undigested food with a diameter of 10 cm. After review of the anamnesis, it was found that preceding the onset of symptoms was the consumption of a large amount of Japanese apples known as kaki apples. The complications of the raw diet whose idea is the absence of heating the food
due to the denaturation of enzymes are poorly known with the few available data from the literature. Nevertheless, different eating habits of patients, especially consumption of persimmons, which represents 29% of all causes of bezoars on a relatively empty stomach has been described as a risk factor that favors the formation of bezoars. During the management of patients with mechanical bowel obstruction although a rare condition bezoars should be considered in the differential diagnosis. Trends in eating habits bring an increasing share of
individuals interested in different types of diets, which present new challenges that health professionals must be familiar with in order to properly treat possible complications.
Keywords
PHYTOBEZOAR; BEZOAR; MECHANICAL OBSTRUCTION; JAPANESE APPLE; RAW FOOD DIET
Hrčak ID:
310282
URI
Publication date:
20.11.2023.
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