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Ball-Valve Obstruction of Terminal Ileum of Long Duration by a Rare Phytobezoar

Rivian Weinerman; Brian Weinerman; Donald F. McIntyre, MD; John A. Hillsman, MD; Arnold G. Rogers, MD,MSC,FRCP(C)
JAMA. 1967;199(4):274-276. doi:10.1001/jama.1967.03120040084021.
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AN UNUSUAL CASE of ball-valve obstruction of the small bowel due to a phytobezoar is being reported, because of the unusually long duration (44 years) it was present. There were associated proximal and distal strictures of the ileum, ulceration, and anemia due to blood loss.

Report of a Case  A 53-year-old mechanic was admitted to the Misericordia General Hospital, Jan 14, 1966, because of black stools, pain in the right lower and left upper quadrants of the abdomen, and anemia.The patient reported May 23, 1956, to his doctor. He complained of abdominal pain, irregular bowel habits, and blood staining on toilet tissue for six months. The pain was crampy, and located in the right lower quadrant. It was associated with bloating and belching and came on about once a week in the midafternoon.Results from a physical examination in 1956 were normal except for small hemorrhoids on anoscopic examination.


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