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Laparoscopic-assisted management of small bowel obstruction due to phytobezoar.

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  • 1Department of Surgery, National University Hospital, Singapore 119074.


Laparoscopy is gaining increasing acceptance for diagnosis and treatment of selected cases of small bowel obstruction. We describe a laparoscopic-assisted procedure used for the treatment of small bowel obstruction caused by a bezoar. A 51-year-old man presented with acute small intestinal obstruction. He had no history of previous abdominal surgery. Diagnostic laparoscopy confirmed a distal ileal obstruction due to an enterolith (bezoar). A limited abdominal incision allowed enterotomy and removal of the obstructing bezoar. Gastroscopy performed a month later showed gastric bezoars which could not be removed endoscopically. Instead, cellulase, a hydrolytic enzyme, was used successfully to treat the condition.

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