Approximately 2-4 % of little colon obstructions (SBO) are due to bezoars. into among four main types: trichobezoar pharmacobezoar lactobezoar and phytobezoar. Trichobezoars are comprised of locks and so are most connected with individuals who’ve a psychiatric disorder  commonly. Pharmacobezoars are comprised of undigested medicine. Lactobezoars are more observed in neonates and so are made up of dairy curd commonly. Phytobezoars are comprised of undigested fibers from vegetables or fruits and so are the most frequent type of bezoar came across being a postoperative problem after gastric bypass . CASE Record A 63-year-old Syrian male shown to the crisis department using a 2-time background of generalized colicky stomach pain connected with repeated throwing up and total constipation. There is no associated history of alteration of bowel habit anal bleeding dysuria or fever. His past health background was significant to get a laparotomy in 1979 because of a peptic ulcer-related problem but he was unacquainted with the facts. He was also lately identified as having diabetes mellitus that he was using organic treatment comprising boiled olive tree leaves (Olea europaea). On physical evaluation the individual appeared unwell but was hemodynamically steady and apyrexial. His stomach was distended. There was a midline laparotomy scar with a reducible incisional hernia in the epigastric area. He had moderate lower abdominal tenderness with no muscle guarding and his bowel sounds were exaggerated. IL3RA Rectal examination revealed no abnormalities and there was a small amount of stool in the rectum. The rest of the physical examination was unremarkable. Routine blood investigation and abdominal X-rays were obtained. Apart from leukocytosis they were unremarkable. A AMD 070 contrast-enhanced CT scan was arranged and it showed features of SBO with collapse of the terminal ileum. There was evidence of a previous gastrojejunostomy with suspected foreign bodies in the stomach and proximal ileum. (Figs?1 and ?and22) . Physique?1: Contrast-enhanced abdominal CT scan in coronal view showing evidence of gastrojejunostomy and visible foreign body in the stomach and features of small bowel obstruction. Physique?2: Sagittal CT scan view showing foreign bodies in the stomach and the ileum with transition point in the small bowel. At laparotomy a previous gastrojejunostomy with dense adhesions in the upper abdomen was found. An obstructing hard foreign body was palpable in the ileum with dilatation of the proximal small bowel loops. A larger comparable foreign body was mobile and palpable AMD 070 within the stomach. (Fig.?3) Both foreign bodies were removed through an enterotomy and gastrotomy respectively and the bowel was decompressed. After limited adhesiolysis the stomach was closed en mass repairing the midline hernia defect. Physique?3: Retrieved phytobezoars. Postoperative recovery was unremarkable except for a short duration of ileus after which the patient made a steady recovery. He was referred to the diabetology department and dietician during admission and was discharged with outpatient clinic follow-up. A follow-up upper GI endoscopy was done and it showed evidence of a hiatus hernia with gastrooesophageal reflux disease. The patient was well controlled on Proton pump inhibitors and AMD 070 remained largely symptom free. DISCUSSION AMD 070 AMD 070 There are numerous predisposing factors that can contribute to the formation of phytobezoars. The most common risk factor is usually previous gastric surgery. The incidence of bezoar formation after gastric surgery ranges from 5 to 12 per cent . The main pathogenesis of bezoar formation is usually believed to be the result of gastric dysmotility and decreased gastric secretions which is very common after any gastric surgery [3 4 Diospyrobezoars formed after persimmon ingestion are a distinct type of phytobezoars characterized by their hard consistency. Coca-Cola ingestion combined with endoscopic techniques has been used effectively to treat gastric phytobezoars and avoid medical procedures . Phytobezoar should be considered in sufferers with prior gastric outlet medical operation who present with colon obstruction and top features of severe surgical abdomen. The current presence of a well-defined intraluminal mass using a mottled gas.