{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T05:32:53Z","timestamp":1781847173825,"version":"3.54.5"},"reference-count":16,"publisher":"BMJ","issue":"2","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2018,12,29]]},"published-print":{"date-parts":[[2019,2]]},"abstract":"<jats:p>Phytobezoars are a rare cause of small bowel obstruction (SBO), which consists of vegetable matter such as seeds, skins, fibres of fruit and vegetables that have solidified. We present the case of a 61-year-old man with no previous surgery who presented with central abdominal pain, nausea and vomiting. An abdominal CT scan demonstrated SBO with a transition point in the left anterior abdomen. He proceeded to a laparoscopy, which revealed multiple perforations throughout the small bowel, from the proximal jejunum to the terminal ileum. Laparotomy was performed, and undigested chestnuts were milked out through the largest perforation and the perforations were oversewn. While obstruction due to phytobezoars is rare, this case demonstrates the importance of considering small bowel trauma and perforation due to phytobezoars and highlights the need for close inspection of the entire gastrointestinal tract for complications in the setting of phytobezoar-related bowel obstruction.<\/jats:p>","DOI":"10.1136\/bcr-2018-227999","type":"journal-article","created":{"date-parts":[[2019,2,4]],"date-time":"2019-02-04T04:15:19Z","timestamp":1549253719000},"page":"bcr-2018-227999","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Small bowel obstruction with multiple perforations post chestnut ingestion"],"prefix":"10.1136","volume":"12","author":[{"given":"Raevin K","family":"Ravindra","sequence":"first","affiliation":[{"name":"Department of General Surgery, Northern Health, Epping, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atandrila","family":"Das","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Northern Health, Epping, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grace L","family":"Chew","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Northern Health, Epping, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Daniel","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Northern Health, Epping, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,2,3]]},"reference":[{"key":"2025082709374784000_12.2.bcr-2018-227999.1","doi-asserted-by":"crossref","first-page":"1813","DOI":"10.3748\/wjg.v11.i12.1813","article-title":"Gastrointestinal bezoars: a retrospective analysis of 34 cases","volume":"11","author":"Erzurumlu","year":"2005","journal-title":"World J Gastroenterol"},{"key":"2025082709374784000_12.2.bcr-2018-227999.2","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1016\/S0039-6109(16)39686-4","article-title":"Phytobezoars following gastric surgery for duodenal ulcer","volume":"52","author":"Buchholz","year":"1972","journal-title":"Surg Clin North Am"},{"key":"2025082709374784000_12.2.bcr-2018-227999.3","first-page":"342","article-title":"Phytobezoar: an uncommon cause of small bowel obstruction","volume":"74","author":"Chisholm","year":"1992","journal-title":"Ann R Coll Surg Engl"},{"key":"2025082709374784000_12.2.bcr-2018-227999.4","doi-asserted-by":"crossref","first-page":"2659","DOI":"10.1007\/s00330-001-1267-0","article-title":"Small bowel obstruction due to phytobezoar: CT diagnosis","volume":"12","author":"Yildirim","year":"2002","journal-title":"Eur Radiol"},{"key":"2025082709374784000_12.2.bcr-2018-227999.5","first-page":"95","article-title":"Management of gastrointestinal bezoars: an analysis of 23 cases","volume":"93","author":"Koulas","year":"2008","journal-title":"Int Surg"},{"key":"2025082709374784000_12.2.bcr-2018-227999.6","doi-asserted-by":"crossref","first-page":"1565","DOI":"10.2169\/internalmedicine.55.6811","article-title":"Repeated small bowel obstruction caused by chestnut ingestion without the formation of phytobezoars","volume":"55","author":"Satake","year":"2016","journal-title":"Intern Med"},{"key":"2025082709374784000_12.2.bcr-2018-227999.7","first-page":"e9","article-title":"Abdominal pain after consuming a chestnut. 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