CT diagnosis of small bowel obstruction due to phytobezoar

Chang Hsien Liou, Chih Yung Yu, Chang Chi Lin, Yu Chen Chao, Yao Chi Liou, Chun Jung Juan, Cheng Yu Chen

Research output: Contribution to journalArticlepeer-review

12 Citations (Scopus)


Background and Purpose: Small bowel obstruction (SBO) is a commonly encountered abdominal problem in the emergency ward. Phytobezoar is an uncommon cause of SBO which has specific radiographic findings on computed tomography (CT). This study evaluated the CT appearance of small bowel phytobezoar. Methods: Eighty two patients with SBO who underwent CT examination and surgical treatment over a 6-year period were included. The presence of fecal ball sign, defined as a clearly distinguishable, ovoid or round intraluminal mass with mottled gas pattern outlined by fluid or oral contrast material in the dilated small bowel at the site of obstruction, and abruptly collapsed lumen beyond the lesion on CT was evaluated in all cases. The CT findings of the patients with SBO and the patients with fecal ball sign on CT were reviewed. The diagnosis was established based on surgical findings. Results: Fecal ball sign was identificed in 9 of the 82 patients. Operative findings revealed that SBO was secondary to phytobezoar in 7 of these patients. The specificity and sensitivity of fecal ball sign in the diagnosis of SBO secondary to phytobezoar were 97% and 100%, respectively. Conclusions: Fecal ball sign is accurate in the preoperative diagnosis of phytobezoar as the underlying cause of SBO. Early recognition of fecal ball sign in the CT study is of paramount importance in precise preoperative diagnosis in patients with SBO.

Original languageEnglish
Pages (from-to)620-624
Number of pages5
JournalJournal of the Formosan Medical Association
Issue number9
Publication statusPublished - Sept 2003
Externally publishedYes


  • Bezoars
  • Diagnosis
  • Differential
  • Intestinal obstruction
  • Retrospective study
  • Tomography
  • X-ray computed

ASJC Scopus subject areas

  • General Medicine


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