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Case Reports in Surgery
Volume 2013 (2013), Article ID 497214, 2 pages
http://dx.doi.org/10.1155/2013/497214
Case Report

An Unusual Cause of Small Bowel Obstruction in a Child: Ingested Rhubarb

1Division of Pediatric Emergency Medicine, Department of Pediatrics, Dana-Dwek Children’s Hospital, Tel-Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel-Aviv University, 6 Weizman Street, 64239 Tel-Aviv, Israel
2Division of Clinical Pharmacology and Toxicology, Ichilov Hospital, Dana-Dwek Children’s Hospital, Tel-Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel-Aviv University, 6 Weizman Street, 64239 Tel-Aviv, Israel
3Department of Pediatric Surgery, Dana-Dwek Children’s Hospital, Tel-Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
4Divisions of Pediatric Emergency Medicine and Clinical Pharmacology and Toxicology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Canada

Received 4 March 2013; Accepted 12 May 2013

Academic Editors: H. Imura and N. Nissen

Copyright © 2013 Miguel Glatstein et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Small bowel obstruction is rarely caused by bezoars concretions formed from undigested foreign material in the gastrointestinal tract. An important cause of bezoars is phytobezoars, formed from vegetables or fruits. A four-year-old boy presented to our emergency department with symptoms of acute intestinal obstruction. Upright plain abdominal radiography revealed multiple air fluid levels. Ultrasound showed no abnormalities, and because of worsening symptoms computed tomography of abdomen was performed. It showed intraluminal obstruction of the terminal ileum. Exploratory laparotomy revealed a phytobezoar consisting of undigested rhubarb. The mass was milked through the large bowel and out the anus. Although rare in humans, bezoars are a well-documented cause of small bowel obstruction and should be considered when intraluminal bowel obstruction occurs. Bezoars causing small bowel obstruction may require surgical treatment.