Phytobezoar in a Meckel’s Diverticulum Associated with Recent Adoption of a Paleolithic Diet

A healthy 33 year old male who had three weeks ago adopted a Paleolithic, or “paleo’ diet, presented with nausea and vomiting. Computed tomography identified a complete small bowel obstruction (SBO) that failed to resolve after initial conservative management. At surgery he was found to have a phytobezoar in conjunction with a Meckel’s diverticulum. We report the first known case of phytobezoar in association with recent adoption of the Paleolithic diet. We discuss the Paleolithic diet as an increasingly significant fad diet in the United States. Furthermore, we discuss diagnostic clues on pre-operative history, physical examination and radiography that may lead to early recognition such as the bowel target sign. Finally, we suggest surgical management (either open, as in this case, or laparoscopic) as treatment and describe our experience in this case of milking the bezoar into the Meckel’s diverticulum prior to resection of the entire lesion. In conclusion, we warn of a possible association between an increasingly used fad diets (1-3 million Americans currently subscribe to the “paleo’ diet), Meckel’s diverticulum (2% of the population) and phytobezoar.