Mango Seed Causing Obstruction in Descending Colon #FirstOfI
Phytobezoars are a very rare cause of large bowel obstruction. Mango seeds as a phytobezoar causing large bowel obstruction have not been reported in the English literature until now. The present case appears in the International Journal of Surgery Case Reports.

A 69-year-old female presented to the Emergency Department with a 1-day history of colicky lower abdominal pain, with no radiation. Prior to this, she experienced constipation over a two-day period for which she took a single laxative dose. She then had 2 small, watery bowel actions followed by pain.

A single episode of vomiting was documented followed by abdominal distension. Physical examination revealed a distended abdomen with generalized tenderness with mild guarding and increased bowel sounds. Digital rectal examination was normal. Abdominal X-rays revealed multiple air/fluid levels with dilated large bowel up to mid-descending colon. No air noted in the rectum.

CT abdomen/pelvis showed a mass within the descending colon with a mottled appearance and there was no free air in the abdomen. On laparotomy, it was noted that mango seeds as a phytobezoar was responsible for the obstruction in the descending colon.

Highlights of the case:-
• Phytobezoars are a rare cause of large bowel obstruction

• It should be included in the differentials in patients with no specific symptoms and signs of colorectal cancers

• Conservative and or Colonoscopic approach should be attempted first, in all patients with no signs of peritonitis

• Patients who present in an acute setting with signs of peritonitis require laparotomy even when the diagnosis is a benign phytobezoar.

Read in detail about the case here: