Abstract
Bezoars are an uncommon but recognised cause of small bowel obstruction (SBO) and are difficult to differentiate preoperatively from other aetiologies. We report a rare case of acute SBO due to a bezoar in a 65-year-old woman who had been on semaglutide, a Glucagon-like peptide-1 (GLP-1) receptor agonist therapy for weight loss. She presented with a four-day history of abdominal pain, distension, nausea, and vomiting. Imaging confirmed SBO. Following unsuccessful nonoperative management, she underwent diagnostic laparoscopy and laparoscopic resection of a jejunal segment containing a large phytobezoar. We postulated that semaglutide-induced gastroparesis and slow intestinal transit may have contributed to bezoar formation and subsequent bowel obstruction. This case highlights a rare but important surgical adverse effect, particularly in patients receiving GLP-1 receptor agonists who present with bowel obstruction.