The following is an image from an abdominal CT scan taken of a 24 year old man who presented with a carbamazepine overdose.

What complication has occurred?

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College Answer

Gastrointestinal obstruction secondary to multi dose charcoal administration.


It is surprisingly difficult to find a CT scan of a charcoal bezoar.

The image above was dredged up using Google, and features a small bowel obstruction due to a bezoar of who knows what.



Watson, William A., Karl F. Cremer, and James A. Chapman. "Gastrointestinal obstruction associated with multiple-dose activated charcoal." The Journal of emergency medicine 4.5 (1986): 401-407.

Goulbourne, Karita Boyd, and James E. Cisek. "Small-bowel obstruction secondary to activated charcoal and adhesions." Annals of emergency medicine 24.1 (1994): 108-110.

Chan, Justin CY, Chaminda Saranasuriya, and Bruce P. Waxman. "Bezoar causing small bowel obstruction after repeated activated charcoal administration." Medical Journal of Australia 183.10 (2005): 537.