Clinics in diagnostic imaging (198). Small bowel obstruction secondary to a bezoar

A 60-year-old man presented with abdominal pain. He was later diagnosed on imaging to have high-grade small bowel obstruction. The patient underwent surgery, and a hard, rounded bezoar resembling the endosperm of Nypa fruticans, colloquially known as attap chee, was found at the point of obstruction. Small bowel obstruction is a common acute surgical condition with multiple causes, including bezoars. We discuss the typical imaging features of bezoars causing small bowel obstruction as well as potential pitfalls that can mimic the appearance of a bezoar.