Seed bezoars as a rare cause of fecal impaction in pediatric patients: A report of two cases from Pakistan

Abstract

Large Bowel obstruction can occur due to numerous etiologies, with seed bezoars being an infrequent one. We herein present two cases of fecal impaction by rectal seed bezoars in pediatric patients for the first time from Pakistan, while also reporting areca nut (betel nut) fecal impaction for the first time in the literature. Our first patient was a 6 year old boy who, having consumed a bag of sunflower seeds, presented to the emergency department with the complaints of constipation and abdominal pain. Our second patient was a 10 year old boy who presented to the emergency department with the complaints of pain in anal region and constipation after ingestion of areca nuts. These cases highlight a severe sequelae of ingestion of seeds/nuts by children, which is the formation of seed bezoars and intestinal obstruction, possibly leading to constipation and other possibly dangerous complications. Although manual dis-impaction under general anesthesia almost always treats these patients, it is equally crucial to create awareness regarding the dangers of consumption of these items, especially in developing countries.

Keywords

• Bezoar
• Sunflower seed bezoar
• Areca nut bezoar
• Intestinal obstruction