Intestinal obstruction caused by a large colorectal lithobezoar in a 7-year-old girl managed at a general hospital in north-central Zambia

Abstract

A colonic bezoar is a mass that develops through the accumulation of indigestible materials within the digestive tract. A lithobezoar is therefore defined as an accumulation of ingested stones or pebbles within the same tract. These are extremely rare clinical entities and more so in peadiatric patients. Having reviewed the literature, we believe it is the first of its kind to be reported in a paediatric patient in Zambia. We therefore hereby report a case of acute mechanical intestinal obstruction secondary to ingestion of multiple small stones in a 7- year- old Zambian girl. She was admitted with a history of constipation and abdominal pains for 2 days. She was reported to have been eating small stones for about a month. She had no associated psychiatric illness. Abdominal X-rays revealed multiple radiopaque masses of various sizes involving the whole colon upto the anus. A diagnosis of acute mechanical intestinal obstruction due to foreign body ingestion was made. Conservative management was instituted with the use of manual evacuation, rectal washouts and oral laxatives. All stones were excreted over a four day period. Diagnostic and therapeutic options are discussed.