AIM:To evaluate the efficacy of cola treatment for gastric phytobezoars,including diospyrobezoars.METHODS:A total of 17 patients(range:48 to 78 years) with symptomatic gastric phytobezoars treated with cola and adjuva...AIM:To evaluate the efficacy of cola treatment for gastric phytobezoars,including diospyrobezoars.METHODS:A total of 17 patients(range:48 to 78 years) with symptomatic gastric phytobezoars treated with cola and adjuvant endoscopic therapy were reviewed.Three liters of cola lavage(10 cases) or drink(7 cases) were initially used,and then endoscopic fragmentation was done for the remnant bezoars by using a lithotripsy basket or a polypectomy snare.The overall success of dissolving a gastric phytobezoars with using three liters of cola and the clinical and endoscopic findings were compared retrospectively between four cases of complete dissolution by using only cola and 13 cases of partial dissolution with cola.RESULTS:After 3 L of cola lavage or drinking,a complete dissolution of bezoars was achieved in four patients(23.5%),while 13 cases(76.5%) were only partially dissolved.Phytobezoars(4 of 6 cases) were observed more frequently than diospyrobezoars(0 of 11) in the group that underwent complete dissolution(P = 0.006).Gender,symptom duration,size of bezoar and method of cola administration were not significantly different between the two groups.Twelve of 13 patients with residual bezoars were completely treated with a combination of cola and endoscopic fragmentation.CONCLUSION:The rate of complete dissolution with three liters of cola was 23.5%,but no case of diospyrobezoar was completely dissolved using this method.However,pretreatment with cola may be helpful and facilitate endoscopic fragmentation of gastric phytobezoars.展开更多
The term bezoar refers to an intraluminal mass in the gastrointestinal system caused by the accumulation of indigestible ingested materials, such as vegetables, fruits, and hair. Bezoars are responsible for 0.4%-4% of...The term bezoar refers to an intraluminal mass in the gastrointestinal system caused by the accumulation of indigestible ingested materials, such as vegetables, fruits, and hair. Bezoars are responsible for 0.4%-4% of cases of mechanical intestinal obstruction. The clinical findings of bezoar-induced ileus do not differ from those of mechanical intestinal obstruction due to other causes. The appearance and localization of bezoars can be established with various imaging methods. Treatment of choice depends on the localization of the bezoar which makes the clinical findings.展开更多
BACKGROUND Gastric bezoars are indigestible masses that can lead to gastrointestinal ob-struction and ulceration.Standard treatments include endoscopic mechanical lithotripsy with a polypectomy snare and Coca-Cola dis...BACKGROUND Gastric bezoars are indigestible masses that can lead to gastrointestinal ob-struction and ulceration.Standard treatments include endoscopic mechanical lithotripsy with a polypectomy snare and Coca-Cola dissolution therapy or a combination of both approaches.However,giant bezoars frequently require multiple treatment sessions and extended hospital stays.Additionally,snare-based mechanical fragmentation may be limited by factors such as bezoar size,shape,density,slipperiness,and restricted working space.In cases where refra-ctory giant bezoars are unresponsive to traditional methods,surgical intervention is often necessary.CASE SUMMARY A 57-year-old male with a history of type 2 diabetes presented with severe epigastric pain and vomiting.Endoscopy revealed two large phytobezoars and a gastric ulcer.Initial attempts at mechanical fragmentation with a polypectomy snare and Coca-Cola ingestion for dissolution were unsuccessful due to the large size and complex structure of the bezoars.An innovative approach using snare-tip electrocautery was then employed.It successfully penetrated the slippery,hard surface of the bezoars and fragmented them into smaller pieces.The patient was subsequently treated with Coca-Cola ingestion,enzyme supplements,and proton pump inhibitors.He was discharged without complications following the endoscopic sessions.CONCLUSION Snare-tip electrocautery is a safe,cost-effective,and minimally invasive alter-native for managing large,refractory gastric bezoars.This is a valuable option in resource-limited settings.展开更多
A phytobezoar is a bezoar or trapped mass in the gastrointestinal system that consists of indigestible plant material such as fibers,skins and seeds.A persimmon phytobezoar(considered to be harder than other types of ...A phytobezoar is a bezoar or trapped mass in the gastrointestinal system that consists of indigestible plant material such as fibers,skins and seeds.A persimmon phytobezoar(considered to be harder than other types of phytobezoars)is formed after frequent consumption of persimmons.The complication of gastrointestinal tract obstruction from bezoars was found to exist in the intestines but was rarely reported in the gastric tract because of its flexible volume.Here we present a 57-yearold man with persimmon phytobezoars,which ultimately led to gastric outlet obstruction.展开更多
Phytobezoars is a rare disease and less common in Western countries.The stomach is the primary site for these formations,and endoscopic treatment involving fragmentation and extraction has traditionally been the most ...Phytobezoars is a rare disease and less common in Western countries.The stomach is the primary site for these formations,and endoscopic treatment involving fragmentation and extraction has traditionally been the most effective approach.However,medical treatments using enzymatic and chemical agents,such as cellulase and Coca-Cola,aimed at dissolving the bezoars,have also been utilized,showing varying degrees of resolution success.Notably,the oral dissolution treatment with Coca-Cola has emerged as a promising,simpler,and more costeffective method.The study by Liu et al represents an important step in clinical research on this topic,despite some limitations that need addressing for a more comprehensive understanding of its findings.Key considerations for future research include sample size calculation,endoscopic procedure details,outpatient vs.inpatient treatment,and detailed cost calculations.The study's exclusions,such as patients with upper gastric surgery,phytobezoars older than 14 d,and cases of gastroparesis,limit its applicability to broader populations,especially in Western countries.Given the promising outcomes of the Coca-Cola treatment,it's advocated as a first-line therapy for phytobezoars.Nonetheless,further research is essential to overcome these limitations.However special situations such as perforation or small bowel obstruction will require surgical treatment.展开更多
BACKGROUND Due to the specificity of Chinese food types,gastric phytobezoars are relatively common in China.Most gastric phytobezoars can be removed by chemical enzyme lysis and endoscopic fragmentation,but the treatm...BACKGROUND Due to the specificity of Chinese food types,gastric phytobezoars are relatively common in China.Most gastric phytobezoars can be removed by chemical enzyme lysis and endoscopic fragmentation,but the treatment for large phytobezoars is limited,and surgical procedures are often required for this difficult problem.CASE SUMMARY For giant gastric phytobezoars that cannot be dissolved and fragmented by conventional treatment,we have invented a new lithotripsy technique(tennis ball cord combined with endoscopy)for these phytobezoars.This non-interventional treatment was successful in a patient whose abdominal pain was immediately relieved,and the gastroscope-induced ulcer healed well 3 d after lithotripsy.The patient was followed-up for 8 wk postoperatively and showed no discomfort such as abdominal pain.CONCLUSION The combination of tennis ball cord and endoscopy for the treatment of giant gastric phytobezoars is feasible and showed high safety and effectiveness,and can be widely applied in hospitals of all sizes.展开更多
BACKGROUND Small bowel bezoar obstruction(SBBO)is a rare clinical condition characterized by hard fecal masses in the small intestine,causing intestinal obstruction.It occurs more frequently in the elderly and bedridd...BACKGROUND Small bowel bezoar obstruction(SBBO)is a rare clinical condition characterized by hard fecal masses in the small intestine,causing intestinal obstruction.It occurs more frequently in the elderly and bedridden patients,but can also affect those with specific gastrointestinal dysfunctions.Diagnosing SBBO is challenging due to its clinical presentation,which mimics other intestinal obstructions.While surgical intervention is the typical treatment for SBBO,advancements in endo-scopic techniques have led to increased use of non-surgical methods,such as endoscopic lithotripsy.CASE SUMMARY We report a case of small bowel obstruction induced by a phytobezoar.A 49-year-old male with a history of type 2 diabetes and long-term persimmon consumption presented to the hospital with symptoms of vomiting,abdominal distension,and constipation.Computed tomography revealed a small bowel obstruction with foreign bodies.Double balloon enteroscopy identified a phytobezoar blocking the intestinal lumen.The bezoar was successfully fragmented using a snare,and the fragments were treated with 100 mL of paraffin oil to facilitate their passage.This case report aims to enhance the understanding of this rare condition by detailing the clinical presentation,diagnostic process,and treatment outcomes of a patient with SBBO.Special attention is given to the application and effectiveness of non-surgical treatment methods,along with strategies to optimize patient manage-ment.CONCLUSION Double balloon enteroscopy combined with sequential laxative therapy is an effective approach for the treatment of a breakable phytobezoar.展开更多
BACKGROUND Large gastric persimmon stones are generally resistant to standard endoscopic treatments.We applied an alternative endoscopic method using a hand-made snare for the treatment of large gastric phytobezoars.A...BACKGROUND Large gastric persimmon stones are generally resistant to standard endoscopic treatments.We applied an alternative endoscopic method using a hand-made snare for the treatment of large gastric phytobezoars.AIM To explore the clinical efficacy of a self-made wire loop snare to treat giant gastric persimmon stones.METHODS A retrospective study evaluated the clinical data of 38 patients with gastroliths admitted to Taihe Hospital in Shiyan City,Hubei Province,China,between March 2015 and October 2020.The patients were divided into observation(n=23)and control(n=15)groups.Patients in the observation group were treated with selfmade wire loop snares for lithotripsy,and patients in the control group were treated with traditional foreign body forceps,snares,injection needles,and other tools.Successful stone removal,treatment time,and hospital stay were compared.RESULTS The average operating time was significantly shorter(P<0.001)in the observation group(53.4 min)than that in the control group(172.8 min).The average hospital stay of the observation group(5.4 d)was significantly shorter(P<0.001)than that in the control group(10.3 d).Successful one-time treatment was significantly more frequent(P<0.001)in the observation group(87%)than in the control group(7%).CONCLUSION Self-made guidewire loop snares were successfully used to treat gastrolithiasis, and were significantly more effective than foreign body forceps, snares, and other traditionalmethods.展开更多
<strong>Introduction:</strong> Small bowel obstruction (SBO) is defined as a complete and persistent cessation of the transit of materials and gases. It occurs in a segment of the digestive tract located b...<strong>Introduction:</strong> Small bowel obstruction (SBO) is defined as a complete and persistent cessation of the transit of materials and gases. It occurs in a segment of the digestive tract located between the pylorus and the colorectal junction. Herein, we report a case of small bowel obstruction (SBO) following excessive consumption of wild grapes with no previous abdomen medical or surgical history. <strong>Presentation of case:</strong> A 65-year-old male farmer presented with cessation of materials and gas associated with vomiting of food and then bilious. The abdomen was bloated and painful on palpation with a moving, painful mass in the left iliac fossa. The hypothesis of acute occlusion of the colon was retained and confirmed on the X-Ray which showed a dilation of small bowel with air-fluid levels. The diagnostic of acute SBO was retained. We performed urgently a median laparotomy. We found the dilation of the loops from the jejunum to the sigmoid colon with a compact mass at the sigmoid colon of 15 cm in length and 6 cm in diameter. We proceeded to crush the mass that was made up with wild grape seed fecal, and push it back to the rectum. The phytobezoar made up with wild grape seeds was extracted through the anus with the fingers after anal dilation. After extraction of the bezoar, the patient’s complaints completely subsided. <strong>Discussion:</strong> SBO is a frequent emergency surgical pathology. SBO induced by phytobezoar often occurs in patients with abdomen surgery history. However, it is particularly rare in virgin abdomen. <strong>Conclusion:</strong> This case report aims to raise awareness of phytobezoar as a cause of SBO in elderly even though without abdomen surgery history.展开更多
AIM: Bezoars (BZ) are the most common foreign bodies of gastrointestinal tract. Clinical manifestations vary depending on the location of BZ from no symptoms to acute abdominal syndrome. When located in small bowel, t...AIM: Bezoars (BZ) are the most common foreign bodies of gastrointestinal tract. Clinical manifestations vary depending on the location of BZ from no symptoms to acute abdominal syndrome. When located in small bowel, they frequently cause small bowel obstruction (SBO). We aimed to present our experience by reviewing literature.METHODS: Thirty-four patients with gastrointestinal BZ were presented. The data were collected from hospital records and analyzed retrospectively. Morbidity and mortality rates were statistically analyzed between the subgroups according to SBO and endoscopic or surgical treatment modalities.RESULTS: The 34 patients had phytobezoars (PBZ). Two patients with mental retardation and trichotillomania had trichobezoars (TBZ). More than half of them (55.88%) had previous gastric surgery. Also most of them had small bowel bezoars resulting in obstruction. Surgical and endoscopic morbidity rates were 32.14% and 14.28% respectively.The total morbidity rate of this study was 29.41%. Four patients in surgically treated group died. There was no death in endoscopically treated group. The total and surgical mortality rates were 11.76% and 14.28% respectively. The differences in morbidity and mortality rates between the subgroups were not statistically significant.CONCLUSION: BZ are commonly seen in stomach and small intestine. SBO is the most common complication.When uncomplicated, endoscopic or surgical removal can be applied easily.展开更多
We reported a case of huge gastric phytobezoar. The gastric phytobezoar was successfully removed through gastrotomy after two failed attempts in endoscopic fragmentation and removal. Disopyrobezoars could be treated e...We reported a case of huge gastric phytobezoar. The gastric phytobezoar was successfully removed through gastrotomy after two failed attempts in endoscopic fragmentation and removal. Disopyrobezoars could be treated either conservatively or surgically. Gastrotomy or laparoscopical management is recommended for the treatment of huge disopyrobezoars.展开更多
Phytobezoar is the most common type of bezoar.It is composed of indigestible vegetable matter and is usually found in the stomach.Biliary phytobezoar is extremely rare and difficult to diagnose preoperatively.The path...Phytobezoar is the most common type of bezoar.It is composed of indigestible vegetable matter and is usually found in the stomach.Biliary phytobezoar is extremely rare and difficult to diagnose preoperatively.The pathogenesis is not clear,and there have been only a few reports of biliary bezoars associated with sphincteric impairmentat the ampulla of Vater.Here,we present a report of biliary bezoar that resulted in jejunal obstruction.We were unable to identifythe bezoar in the extrahepatic bile duct until it obstructed the small bowel lumen.To our knowledge,this is the first report of small bowel obstruction resulting frommigration of a biliary bezoar.展开更多
A phytobezoar is one of the intraluminal causes of gastric outlet obstruction,especially in patients with previous gastric surgery and/or gastric motility disorders.Before the proton pump inhibitor era,vagotomy,pyloro...A phytobezoar is one of the intraluminal causes of gastric outlet obstruction,especially in patients with previous gastric surgery and/or gastric motility disorders.Before the proton pump inhibitor era,vagotomy,pyloroplasty,gastrectomy and gastrojejunostomy were commonly performed procedures in peptic ulcer patients.One of the sequelae of gastrojejunostomy is phytobezoar formation.However,a bezoar causing gastric outlet obstruction is rare even with giant gastric bezoars.We report a rare case of gastric outlet obstruction due to a phytobezoar obstructing the efferent limb of the gastrojejunostomy site.This phytobezoar which consisted of a whole piece of okra(lady finger vegetable) was successfully removed by endoscopic snare.To the best of our knowledge,this is the first case of okra bezoar-related gastrojejunostomy efferent limb obstruction reported in the literature.展开更多
文摘AIM:To evaluate the efficacy of cola treatment for gastric phytobezoars,including diospyrobezoars.METHODS:A total of 17 patients(range:48 to 78 years) with symptomatic gastric phytobezoars treated with cola and adjuvant endoscopic therapy were reviewed.Three liters of cola lavage(10 cases) or drink(7 cases) were initially used,and then endoscopic fragmentation was done for the remnant bezoars by using a lithotripsy basket or a polypectomy snare.The overall success of dissolving a gastric phytobezoars with using three liters of cola and the clinical and endoscopic findings were compared retrospectively between four cases of complete dissolution by using only cola and 13 cases of partial dissolution with cola.RESULTS:After 3 L of cola lavage or drinking,a complete dissolution of bezoars was achieved in four patients(23.5%),while 13 cases(76.5%) were only partially dissolved.Phytobezoars(4 of 6 cases) were observed more frequently than diospyrobezoars(0 of 11) in the group that underwent complete dissolution(P = 0.006).Gender,symptom duration,size of bezoar and method of cola administration were not significantly different between the two groups.Twelve of 13 patients with residual bezoars were completely treated with a combination of cola and endoscopic fragmentation.CONCLUSION:The rate of complete dissolution with three liters of cola was 23.5%,but no case of diospyrobezoar was completely dissolved using this method.However,pretreatment with cola may be helpful and facilitate endoscopic fragmentation of gastric phytobezoars.
文摘The term bezoar refers to an intraluminal mass in the gastrointestinal system caused by the accumulation of indigestible ingested materials, such as vegetables, fruits, and hair. Bezoars are responsible for 0.4%-4% of cases of mechanical intestinal obstruction. The clinical findings of bezoar-induced ileus do not differ from those of mechanical intestinal obstruction due to other causes. The appearance and localization of bezoars can be established with various imaging methods. Treatment of choice depends on the localization of the bezoar which makes the clinical findings.
文摘BACKGROUND Gastric bezoars are indigestible masses that can lead to gastrointestinal ob-struction and ulceration.Standard treatments include endoscopic mechanical lithotripsy with a polypectomy snare and Coca-Cola dissolution therapy or a combination of both approaches.However,giant bezoars frequently require multiple treatment sessions and extended hospital stays.Additionally,snare-based mechanical fragmentation may be limited by factors such as bezoar size,shape,density,slipperiness,and restricted working space.In cases where refra-ctory giant bezoars are unresponsive to traditional methods,surgical intervention is often necessary.CASE SUMMARY A 57-year-old male with a history of type 2 diabetes presented with severe epigastric pain and vomiting.Endoscopy revealed two large phytobezoars and a gastric ulcer.Initial attempts at mechanical fragmentation with a polypectomy snare and Coca-Cola ingestion for dissolution were unsuccessful due to the large size and complex structure of the bezoars.An innovative approach using snare-tip electrocautery was then employed.It successfully penetrated the slippery,hard surface of the bezoars and fragmented them into smaller pieces.The patient was subsequently treated with Coca-Cola ingestion,enzyme supplements,and proton pump inhibitors.He was discharged without complications following the endoscopic sessions.CONCLUSION Snare-tip electrocautery is a safe,cost-effective,and minimally invasive alter-native for managing large,refractory gastric bezoars.This is a valuable option in resource-limited settings.
文摘A phytobezoar is a bezoar or trapped mass in the gastrointestinal system that consists of indigestible plant material such as fibers,skins and seeds.A persimmon phytobezoar(considered to be harder than other types of phytobezoars)is formed after frequent consumption of persimmons.The complication of gastrointestinal tract obstruction from bezoars was found to exist in the intestines but was rarely reported in the gastric tract because of its flexible volume.Here we present a 57-yearold man with persimmon phytobezoars,which ultimately led to gastric outlet obstruction.
文摘Phytobezoars is a rare disease and less common in Western countries.The stomach is the primary site for these formations,and endoscopic treatment involving fragmentation and extraction has traditionally been the most effective approach.However,medical treatments using enzymatic and chemical agents,such as cellulase and Coca-Cola,aimed at dissolving the bezoars,have also been utilized,showing varying degrees of resolution success.Notably,the oral dissolution treatment with Coca-Cola has emerged as a promising,simpler,and more costeffective method.The study by Liu et al represents an important step in clinical research on this topic,despite some limitations that need addressing for a more comprehensive understanding of its findings.Key considerations for future research include sample size calculation,endoscopic procedure details,outpatient vs.inpatient treatment,and detailed cost calculations.The study's exclusions,such as patients with upper gastric surgery,phytobezoars older than 14 d,and cases of gastroparesis,limit its applicability to broader populations,especially in Western countries.Given the promising outcomes of the Coca-Cola treatment,it's advocated as a first-line therapy for phytobezoars.Nonetheless,further research is essential to overcome these limitations.However special situations such as perforation or small bowel obstruction will require surgical treatment.
文摘BACKGROUND Due to the specificity of Chinese food types,gastric phytobezoars are relatively common in China.Most gastric phytobezoars can be removed by chemical enzyme lysis and endoscopic fragmentation,but the treatment for large phytobezoars is limited,and surgical procedures are often required for this difficult problem.CASE SUMMARY For giant gastric phytobezoars that cannot be dissolved and fragmented by conventional treatment,we have invented a new lithotripsy technique(tennis ball cord combined with endoscopy)for these phytobezoars.This non-interventional treatment was successful in a patient whose abdominal pain was immediately relieved,and the gastroscope-induced ulcer healed well 3 d after lithotripsy.The patient was followed-up for 8 wk postoperatively and showed no discomfort such as abdominal pain.CONCLUSION The combination of tennis ball cord and endoscopy for the treatment of giant gastric phytobezoars is feasible and showed high safety and effectiveness,and can be widely applied in hospitals of all sizes.
文摘BACKGROUND Small bowel bezoar obstruction(SBBO)is a rare clinical condition characterized by hard fecal masses in the small intestine,causing intestinal obstruction.It occurs more frequently in the elderly and bedridden patients,but can also affect those with specific gastrointestinal dysfunctions.Diagnosing SBBO is challenging due to its clinical presentation,which mimics other intestinal obstructions.While surgical intervention is the typical treatment for SBBO,advancements in endo-scopic techniques have led to increased use of non-surgical methods,such as endoscopic lithotripsy.CASE SUMMARY We report a case of small bowel obstruction induced by a phytobezoar.A 49-year-old male with a history of type 2 diabetes and long-term persimmon consumption presented to the hospital with symptoms of vomiting,abdominal distension,and constipation.Computed tomography revealed a small bowel obstruction with foreign bodies.Double balloon enteroscopy identified a phytobezoar blocking the intestinal lumen.The bezoar was successfully fragmented using a snare,and the fragments were treated with 100 mL of paraffin oil to facilitate their passage.This case report aims to enhance the understanding of this rare condition by detailing the clinical presentation,diagnostic process,and treatment outcomes of a patient with SBBO.Special attention is given to the application and effectiveness of non-surgical treatment methods,along with strategies to optimize patient manage-ment.CONCLUSION Double balloon enteroscopy combined with sequential laxative therapy is an effective approach for the treatment of a breakable phytobezoar.
基金2016 Joint Diagnostic Medicine Research Project of Taihe Hospital,No.2016JD02.
文摘BACKGROUND Large gastric persimmon stones are generally resistant to standard endoscopic treatments.We applied an alternative endoscopic method using a hand-made snare for the treatment of large gastric phytobezoars.AIM To explore the clinical efficacy of a self-made wire loop snare to treat giant gastric persimmon stones.METHODS A retrospective study evaluated the clinical data of 38 patients with gastroliths admitted to Taihe Hospital in Shiyan City,Hubei Province,China,between March 2015 and October 2020.The patients were divided into observation(n=23)and control(n=15)groups.Patients in the observation group were treated with selfmade wire loop snares for lithotripsy,and patients in the control group were treated with traditional foreign body forceps,snares,injection needles,and other tools.Successful stone removal,treatment time,and hospital stay were compared.RESULTS The average operating time was significantly shorter(P<0.001)in the observation group(53.4 min)than that in the control group(172.8 min).The average hospital stay of the observation group(5.4 d)was significantly shorter(P<0.001)than that in the control group(10.3 d).Successful one-time treatment was significantly more frequent(P<0.001)in the observation group(87%)than in the control group(7%).CONCLUSION Self-made guidewire loop snares were successfully used to treat gastrolithiasis, and were significantly more effective than foreign body forceps, snares, and other traditionalmethods.
文摘<strong>Introduction:</strong> Small bowel obstruction (SBO) is defined as a complete and persistent cessation of the transit of materials and gases. It occurs in a segment of the digestive tract located between the pylorus and the colorectal junction. Herein, we report a case of small bowel obstruction (SBO) following excessive consumption of wild grapes with no previous abdomen medical or surgical history. <strong>Presentation of case:</strong> A 65-year-old male farmer presented with cessation of materials and gas associated with vomiting of food and then bilious. The abdomen was bloated and painful on palpation with a moving, painful mass in the left iliac fossa. The hypothesis of acute occlusion of the colon was retained and confirmed on the X-Ray which showed a dilation of small bowel with air-fluid levels. The diagnostic of acute SBO was retained. We performed urgently a median laparotomy. We found the dilation of the loops from the jejunum to the sigmoid colon with a compact mass at the sigmoid colon of 15 cm in length and 6 cm in diameter. We proceeded to crush the mass that was made up with wild grape seed fecal, and push it back to the rectum. The phytobezoar made up with wild grape seeds was extracted through the anus with the fingers after anal dilation. After extraction of the bezoar, the patient’s complaints completely subsided. <strong>Discussion:</strong> SBO is a frequent emergency surgical pathology. SBO induced by phytobezoar often occurs in patients with abdomen surgery history. However, it is particularly rare in virgin abdomen. <strong>Conclusion:</strong> This case report aims to raise awareness of phytobezoar as a cause of SBO in elderly even though without abdomen surgery history.
文摘AIM: Bezoars (BZ) are the most common foreign bodies of gastrointestinal tract. Clinical manifestations vary depending on the location of BZ from no symptoms to acute abdominal syndrome. When located in small bowel, they frequently cause small bowel obstruction (SBO). We aimed to present our experience by reviewing literature.METHODS: Thirty-four patients with gastrointestinal BZ were presented. The data were collected from hospital records and analyzed retrospectively. Morbidity and mortality rates were statistically analyzed between the subgroups according to SBO and endoscopic or surgical treatment modalities.RESULTS: The 34 patients had phytobezoars (PBZ). Two patients with mental retardation and trichotillomania had trichobezoars (TBZ). More than half of them (55.88%) had previous gastric surgery. Also most of them had small bowel bezoars resulting in obstruction. Surgical and endoscopic morbidity rates were 32.14% and 14.28% respectively.The total morbidity rate of this study was 29.41%. Four patients in surgically treated group died. There was no death in endoscopically treated group. The total and surgical mortality rates were 11.76% and 14.28% respectively. The differences in morbidity and mortality rates between the subgroups were not statistically significant.CONCLUSION: BZ are commonly seen in stomach and small intestine. SBO is the most common complication.When uncomplicated, endoscopic or surgical removal can be applied easily.
文摘We reported a case of huge gastric phytobezoar. The gastric phytobezoar was successfully removed through gastrotomy after two failed attempts in endoscopic fragmentation and removal. Disopyrobezoars could be treated either conservatively or surgically. Gastrotomy or laparoscopical management is recommended for the treatment of huge disopyrobezoars.
文摘Phytobezoar is the most common type of bezoar.It is composed of indigestible vegetable matter and is usually found in the stomach.Biliary phytobezoar is extremely rare and difficult to diagnose preoperatively.The pathogenesis is not clear,and there have been only a few reports of biliary bezoars associated with sphincteric impairmentat the ampulla of Vater.Here,we present a report of biliary bezoar that resulted in jejunal obstruction.We were unable to identifythe bezoar in the extrahepatic bile duct until it obstructed the small bowel lumen.To our knowledge,this is the first report of small bowel obstruction resulting frommigration of a biliary bezoar.
文摘A phytobezoar is one of the intraluminal causes of gastric outlet obstruction,especially in patients with previous gastric surgery and/or gastric motility disorders.Before the proton pump inhibitor era,vagotomy,pyloroplasty,gastrectomy and gastrojejunostomy were commonly performed procedures in peptic ulcer patients.One of the sequelae of gastrojejunostomy is phytobezoar formation.However,a bezoar causing gastric outlet obstruction is rare even with giant gastric bezoars.We report a rare case of gastric outlet obstruction due to a phytobezoar obstructing the efferent limb of the gastrojejunostomy site.This phytobezoar which consisted of a whole piece of okra(lady finger vegetable) was successfully removed by endoscopic snare.To the best of our knowledge,this is the first case of okra bezoar-related gastrojejunostomy efferent limb obstruction reported in the literature.
