4.4 Article

Harry Potter's Occlusion: Report of a Case of Pumpkin Seed Bezoar Rectal Impact

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FRONTIERS IN SURGERY
卷 9, 期 -, 页码 -

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FRONTIERS MEDIA SA
DOI: 10.3389/fsurg.2022.902701

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pumpkin seeds; bezoar; occlusion; haematochezia; digital impaction; depression

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Bezoar is an undigested substance found in the intestines of humans or animals, often causing constipation and pain. This article reports a case of pumpkin seed bezoars causing abdominal pain, constipation, and rectal problems, which was successfully resolved through manual disimpaction.
Bezoar is a term from Arabic bazahr or ultimately from Middle Persian p'tzhl ( padzahr, bezoar antidote or less commonaly aegagropile or egagropile (2-4). It was believed to have the power of a universal antidote that works against any poison, and a glass containing a bezoar could neutralize any poison poured into it. In science, it is a mass of hair or undigested vegetable matter found in a human or animal intestines, similar to a hairball. Otherwise, the name could derive from a kind of Turkish goat whose name is just bezoar. Usually, it is found trapped in every part of the gastrointestinal system and must be distinguished by pseudobezoar, which is an nondigestible object voluntarily introduced into the digestive tract. The most common causes are a previous gastric surgery such as a gastric band (for weight loss) or gastric bypass, a reduced stomach acid (hypochlorhydria) or decreased stomach size, and a delayed gastric emptying, typically due to diabetes, autoimmune disorders, or mixed connective tissue disease. Seed bezoars are usually found in the rectum of patients without predisposing factors, causing constipation and pain. Rectal impaction is common after ingestion of seeds, while a true occlusion is rare. Although several cases of phytobezoars composed of various types of seeds are reported in the literature, bezoars of pumpkin seeds have rarely been reported. The authors report a case of fecal impaction by pumpkin seed bezoars with abdominal pain: a difficulty to void with subsequent rectal inflammation and hemorrhoid enlargement was observed. The patient underwent a successful manual disimpaction.

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