Zin T, Maw M, Pai DR, Paijan RB, Kyi M. Efferent limb of gastrojejunostomy obstruction by a whole okra phytobezoar: Case report and brief review. World J Gastrointest Endosc 2012; 4(5): 197-200 [PMID: 22624073 DOI: 10.4253/wjge.v4.i5.197]
Corresponding Author of This Article
Thant Zin, FRCS, Associate Professor, Department of Surgery, Melaka Manipal Medical College, Jalan Batu Hampar, Bukit Baru, 75150 Melaka, Malaysia. thant.zin@manipal.edu.my
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Thant Zin, Myat Maw, Dinker Ramananda Pai, Department of Surgery, Melaka Manipal Medical College, 75150 Melaka, Malaysia
Rosaini Binti Paijan, Myo Kyi, Department of Surgery, Hospital Pakar Sultanah Fatimah, Muar Johor, Malaysia
Author contributions: Thant Z revised the manuscript and performed data research; Maw M acquired patient information and drafted the manuscript; Pai DR reviewed the manuscript and provided discussion points; Paijan RB and Kyi M helped to obtain patient consent, helped with patient management and amended the manuscript.
Correspondence to: Thant Zin, FRCS, Associate Professor, Department of Surgery, Melaka Manipal Medical College, Jalan Batu Hampar, Bukit Baru, 75150 Melaka, Malaysia. thant.zin@manipal.edu.my
Telephone: +606-2925849 Fax: +606-2925852
Received: April 11, 2011 Revised: January 1, 2012 Accepted: April 27, 2012 Published online: May 16, 2012
Abstract
A phytobezoar is one of the intraluminal causes of gastric outlet obstruction, especially in patients with previous gastric surgery and/or gastric motility disorders. Before the proton pump inhibitor era, vagotomy, pyloroplasty, gastrectomy and gastrojejunostomy were commonly performed procedures in peptic ulcer patients. One of the sequelae of gastrojejunostomy is phytobezoar formation. However, a bezoar causing gastric outlet obstruction is rare even with giant gastric bezoars. We report a rare case of gastric outlet obstruction due to a phytobezoar obstructing the efferent limb of the gastrojejunostomy site. This phytobezoar which consisted of a whole piece of okra (lady finger vegetable) was successfully removed by endoscopic snare. To the best of our knowledge, this is the first case of okra bezoar-related gastrojejunostomy efferent limb obstruction reported in the literature.
