Acute intestinal obstruction due to sponge bezoar in a patient with a history of eating disorders: a case report
Source: PubMed Central Open Access, NCBI / U.S. National Library of Medicine
Introduction and importance: Foreign body (FB) ingestion and impaction in the gastrointestinal (GI) tract are frequent occurrences, particularly among children and individuals with psychiatric disorders. Although most FBs pass spontaneously, some may lead to serious complications, including intestinal obstruction and perforation. Bezoars composed of non-food materials, such as sponges, are exceptionally rare and are often associated with psychiatric illness or pica. Case presentation: We report the case of a 22-year-old woman with a history of eating disorders and voluntary ingestion of sponges, who presented with symptoms of acute intestinal obstruction. Imaging revealed a spongiform bezoar in the distal ileum. Surgical exploration confirmed multiple sponge bezoars in the ileum and stomach. A gastrotomy and double enterotomy were performed to extract the foreign bodies. The postoperative course was uneventful. Clinical discussion: Management of FB ingestion depends on the object’s nature, location, and associated complications. While most cases are managed conservatively, surgical intervention is indicated when obstruction, perforation, or lack of progression occurs. Sponge bezoars are particularly rare and are frequently associated with psychiatric disorders. In this case, repeated voluntary ingestion resulted in multiple bezoars requiring surgical removal. Psychiatric evaluation and long-term follow-up are essential to prevent recurrence. Conclusion: FB ingestion should be
Abstract
Introduction and importance: Foreign body (FB) ingestion and impaction in the gastrointestinal (GI) tract are frequent occurrences, particularly among children and individuals with psychiatric disorders. Although most FBs pass spontaneously, some may lead to serious complications, including intestinal obstruction and perforation. Bezoars composed of non-food materials, such as sponges, are exceptionally rare and are often associated with psychiatric illness or pica. Case presentation: We report the case of a 22-year-old woman with a history of eating disorders and voluntary ingestion of sponges, who presented with symptoms of acute intestinal obstruction. Imaging revealed a spongiform bezoar in the distal ileum. Surgical exploration confirmed multiple sponge bezoars in the ileum and stomach. A gastrotomy and double enterotomy were performed to extract the foreign bodies. The postoperative course was uneventful. Clinical discussion: Management of FB ingestion depends on the object’s nature, location, and associated complications. While most cases are managed conservatively, surgical intervention is indicated when obstruction, perforation, or lack of progression occurs. Sponge bezoars are particularly rare and are frequently associated with psychiatric disorders. In this case, repeated voluntary ingestion resulted in multiple bezoars requiring surgical removal. Psychiatric evaluation and long-term follow-up are essential to prevent recurrence. Conclusion: FB ingestion should be considered a possible cause of intestinal obstruction in patients with psychiatric comorbidities. Early diagnosis and prompt surgical management are vital to prevent severe complications, and multidisciplinary follow-up is crucial to address the underlying behavioral causes.