Location
Moultrie, GA
Start Date
9-5-2023 1:00 PM
End Date
9-5-2023 4:00 PM
Description
Introduction: Bezoars are aggregates of undigested plant fibers, hair, or seeds that may impact in any portion of the GI tract. These bezoars if left can lead to significant complications, including perforation and peritonitis.
Methods: We report a case of a 4-year-old female patient who presented to the emergency department with constipation and severe lower abdominal pain following unsupervised consumption of a large unknown volume of sunflower seeds. Initial radiograph revealed an undigested bezoar of seeds in the sigmoid colon and rectum. The patient was managed with mineral oil enema and manual disimpaction under conscious sedation. Subsequent radiographs revealed a large seed burden remaining in the colon after repeat disimpaction. The patient was discharged after 48 hours of observation with instructions to the parents to return if any worsening pain or distention was noted. We conducted a review of the literature to analyze cases of patients with fecal impaction secondary to seed bezoars.
Results: Previous reports in the literature document the use of enema and digital disimpaction for management of seed bezoars. Some reports recommend possible endoscopy or surgical management for retrieval of seeds if complications such as GI ulceration occur secondary to impaction.
Discussion: Management of seed bezoars is dependent on various factors, such as the location of the bezoar in the GI tract, the size of the seed burden, and the degree of symptomatology and complications from the impaction. Future directions of research involve investigating the resolution of impaction over time, the frequency of follow-up visits, and necessity for endoscopic procedures vs. serial imaging to monitor patients after discharge.
Embargo Period
7-10-2023
Included in
Management of patient with impaction secondary to undigested sunflower seed bezoar: A case report
Moultrie, GA
Introduction: Bezoars are aggregates of undigested plant fibers, hair, or seeds that may impact in any portion of the GI tract. These bezoars if left can lead to significant complications, including perforation and peritonitis.
Methods: We report a case of a 4-year-old female patient who presented to the emergency department with constipation and severe lower abdominal pain following unsupervised consumption of a large unknown volume of sunflower seeds. Initial radiograph revealed an undigested bezoar of seeds in the sigmoid colon and rectum. The patient was managed with mineral oil enema and manual disimpaction under conscious sedation. Subsequent radiographs revealed a large seed burden remaining in the colon after repeat disimpaction. The patient was discharged after 48 hours of observation with instructions to the parents to return if any worsening pain or distention was noted. We conducted a review of the literature to analyze cases of patients with fecal impaction secondary to seed bezoars.
Results: Previous reports in the literature document the use of enema and digital disimpaction for management of seed bezoars. Some reports recommend possible endoscopy or surgical management for retrieval of seeds if complications such as GI ulceration occur secondary to impaction.
Discussion: Management of seed bezoars is dependent on various factors, such as the location of the bezoar in the GI tract, the size of the seed burden, and the degree of symptomatology and complications from the impaction. Future directions of research involve investigating the resolution of impaction over time, the frequency of follow-up visits, and necessity for endoscopic procedures vs. serial imaging to monitor patients after discharge.