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Small bowel obstruction caused by phytobezoar and associated with vitamin [B.sub.12] deficiency.

Publication: Southern Medical Journal
Publication Date: 01-SEP-06 		Format: Online
Delivery: Immediate Online Access
Full Article Title: Small bowel obstruction caused by phytobezoar and associated with vitamin [B.sub.12] deficiency.(Letter to the editor)

Article Excerpt
To the Editor: A 57-year-old male patient presented with vomiting 2 hours after a meal; he had also been experiencing abdominal pain, constipation and obstipation for 2 weeks. One week earlier, at another healthcare center, an upper gastrointestinal system endoscopic examination showed phytobezoar at the bulbus, reflux gastritis and gastric ulcer. He had no gastric surgery but had a history of eating persimmons and subclinical diabetes. On physical examination, epigastric tenderness and clapotage was determined. Both erytro-cyte sedimentation rate (68 mm/h) and C-reactive protein were high (52 mg/L). Vitamin [B.sub.12] level was low (130 pg/mL, range 160-900 pg/mL). Plain abdominal radiography showed gaseous distention of the small bowel. Repeated endoscopic examination showed esophagitis stage 2, alkaline reflux pangastritis and gastric and duodenal ulcer. Colonoscopic examination was normal. Electromyogram revealed sensorial and motor polyneuropathy....

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