{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T11:59:57Z","timestamp":1777377597088,"version":"3.51.4"},"reference-count":13,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2014,11,27]]},"abstract":"<jats:p>Primary small bowel bezoars constitute 0.44% of small bowel obstructions (SBO). We report a case of a man with a history of gastroplasty who presented with lower abdominal pain. Initial examination revealed leucocytosis and serum lipase. CT of the abdomen\/pelvis was consistent with pancreatitis, cholelithiasis and a stable, 3.8\u2005cm, ampullary diverticulum, without obstruction of the pancreatic\/common bile duct. Considering this was the patient's first episode of pancreatitis with evidence of cholelithiasis, it seemed prudent that he would benefit from cholecystectomy but not diverticulectomy. Post-cholecystectomy he represented to the hospital with biliary emesis. CT of the abdomen\/pelvis revealed postsurgical changes. Owing to non-resolution of the symptoms, 48\u2005h later a small bowel follow-through was obtained that suggested partial SBO. Ultimately, the patient was taken for exploratory laparoscopy and small bowel resection, after a large intramural mass was encountered in the small bowel. Final pathology revealed a 3\u2005cm biliary bezoar causing obstruction and stercoral ulceration.<\/jats:p>","DOI":"10.1136\/bcr-2014-207455","type":"journal-article","created":{"date-parts":[[2014,12,10]],"date-time":"2014-12-10T07:54:35Z","timestamp":1418198075000},"page":"bcr2014207455","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["An unusual case of biliary bezoar causing small bowel obstruction in a patient with ampullary diverticulum and stapled gastroplasty"],"prefix":"10.1136","volume":"2014","author":[{"given":"Awais","family":"Ashfaq","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"II","given":"James A","family":"Madura","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alyssa B","family":"Chapital","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2014,12,9]]},"reference":[{"key":"2025042707062459000_2014.dec09_1.bcr2014207455.1","first-page":"476","article-title":"Bezoars: classification, pathophysiology, and treatment","volume":"83","author":"Andrus","year":"1988","journal-title":"Am J Gastroenterol"},{"key":"2025042707062459000_2014.dec09_1.bcr2014207455.2","first-page":"789","article-title":"[Intestinal obstruction caused by phytobezoar: computerized tomography findings. Report of 3 cases]","volume":"93","author":"Angelelli","year":"1997","journal-title":"Radiol Med"},{"key":"2025042707062459000_2014.dec09_1.bcr2014207455.3","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800810723"},{"key":"2025042707062459000_2014.dec09_1.bcr2014207455.4","doi-asserted-by":"crossref","first-page":"e4","DOI":"10.2349\/biij.1.1.e4","article-title":"Phytobezoar: an unusual cause of intestinal obstruction","volume":"1","author":"Teng","year":"2005","journal-title":"Biomed Imaging Interv J"},{"key":"2025042707062459000_2014.dec09_1.bcr2014207455.5","doi-asserted-by":"publisher","DOI":"10.1007\/s002619900198"},{"key":"2025042707062459000_2014.dec09_1.bcr2014207455.6","first-page":"313","article-title":"Intestinal obstruction due to bezoars","volume":"79","author":"Goldstein","year":"1984","journal-title":"Am J Gastroenterol"},{"key":"2025042707062459000_2014.dec09_1.bcr2014207455.7","first-page":"1346","article-title":"Biliary phytobezoar: a medical curiosity","volume":"90","author":"Lamotte","year":"1995","journal-title":"Am J Gastroenterol"},{"key":"2025042707062459000_2014.dec09_1.bcr2014207455.8","doi-asserted-by":"publisher","DOI":"10.1155\/1993\/51546"},{"key":"2025042707062459000_2014.dec09_1.bcr2014207455.9","doi-asserted-by":"publisher","DOI":"10.1055\/s-1999-36"},{"key":"2025042707062459000_2014.dec09_1.bcr2014207455.10","doi-asserted-by":"publisher","DOI":"10.1186\/1471-230X-6-1"},{"key":"2025042707062459000_2014.dec09_1.bcr2014207455.11","doi-asserted-by":"crossref","first-page":"E93","DOI":"10.1177\/000313481307900218","article-title":"Laparoscopic-assisted extirpation of a phytobezoar causing small bowel obstruction after Roux-en-Y laparoscopic gastric bypass","volume":"79","author":"Parsi","year":"2013","journal-title":"Am Surg"},{"key":"2025042707062459000_2014.dec09_1.bcr2014207455.12","first-page":"741","article-title":"[Cholestasis caused by an intradiverticular bezoar. Endoscopic treatment]","volume":"13","author":"Seyrig","year":"1989","journal-title":". Gastroenterol Clin Biol"},{"key":"2025042707062459000_2014.dec09_1.bcr2014207455.13","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v18.i9.960"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2014-207455","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,27]],"date-time":"2025-04-27T14:06:36Z","timestamp":1745762796000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2014-207455"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,12,9]]},"references-count":13,"alternative-id":["10.1136\/bcr-2014-207455"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2014-207455","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,12,9]]}}}