PHẪU THUẬT NỘI SOI HOÀN TOÀN MỞ RUỘT NON LẤY BÃ THỨC ĂN: BÁO CÁO CA LÂM SÀNG VÀ ĐIỂM LẠI Y VĂN

Abstract

Intestinal obstruction is a common surgical emergency. Among its causes, phytobezoars are rare, accounting for approximately 2–4% of cases. Bezoars typically form in the stomach and migrate into the small intestine, where they may cause obstruction. Conventional open surgery has been the standard treatment; however, laparoscopic surgery has increasingly been shown to be effective, safe, and associated with faster recovery.We report a case of small bowel obstruction caused by a phytobezoar that was successfully treated by totally laparoscopic enterotomy with bezoar extraction—a technique that, to our knowledge, has not been previously reported in Vietnam. The patient was a 77-year-old woman with a history of hypertension, diabetes mellitus, and two prior abdominal surgeries, who was admitted with colicky abdominal pain and vomiting. Upper gastrointestinal endoscopy and abdominal computed tomography confirmed small bowel obstruction due to a jejunal phytobezoar measuring 4 × 4 × 5 cm. The patient underwent totally laparoscopic enterotomy with bezoar removal, had an uneventful postoperative course, and was discharged after 5 days. Through this case, we review the literature on the diagnosis and management of bezoar-induced intestinal obstruction, with particular emphasis on minimally invasive laparoscopic surgery.