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
The formation of a bezoar is a relatively infrequentdisorder that affects the gastrointestinal system.Bezoars are mainly classified into four types dependingon the material constituting the indigestible mass of thebez...The formation of a bezoar is a relatively infrequentdisorder that affects the gastrointestinal system.Bezoars are mainly classified into four types dependingon the material constituting the indigestible mass of thebezoar phytobezoars, trichobezoars, pharmacobezoars,and lactobezoars. Gastric bezoars often cause ulcerativelesions in the stomach and subsequent bleeding,whereas small intestinal bezoars present with smallbowel obstruction and ileus. A number of articles haveemphasized the usefulness of Coca-Cola？ administrationfor the dissolution of phytobezoars. However, persimmonphytobezoars may be resistant to such dissolutiontreatment because of their harder consistency comparedto other types of phytobezoars. Better understanding ofthe etiology and epidemiology of each type of bezoarwill facilitate prompt diagnosis and management.Here we provide an overview of the prevalence, classification,predisposing factors, and manifestations ofbezoars. Diagnosis and management strategies arealso discussed, reviewing mainly our own case series.Recent progress in basic research regarding persimmonphytobezoars is also briefly reviewed.展开更多
BACKGROUND Gastric phytobezoars(GPBs)are very common in northern China.Combined therapy involving carbonated beverage consumption and endoscopic lithotripsy has been shown to be effective and safe.Existing studies on ...BACKGROUND Gastric phytobezoars(GPBs)are very common in northern China.Combined therapy involving carbonated beverage consumption and endoscopic lithotripsy has been shown to be effective and safe.Existing studies on this subject are often case reports highlighting the successful dissolution of phytobezoars through Coca-Cola consumption.Consequently,large-scale prospective investigations in this domain remain scarce.Therefore,we conducted a randomized controlled trial to examine the effects of Coca-Cola consumption on GPBs.AIM To evaluate the impact of Coca-Cola on GPBs,including the dissolution rate,medical expenses,ulcer rate,and operation time.METHODS A total of 160 consecutive patients diagnosed with GPBs were allocated into two groups(a control group and an intervention group)through computer-generated randomization.Patients in the intervention group received a Coca-Cola-based regimen(Coca-Cola 2000-4000 mL per day for 7 d),while those in the control group underwent emergency fragmentation.RESULTS Complete dissolution of GPBs was achieved in 100% of the patients in the intervention group.The disparity in expenses between the control group and intervention group(t=25.791,P=0.000)was statistically significant,and the difference in gastric ulcer occurrence between the control group and intervention group(χ^(2)=6.181,P=0.013)was also statistically significant.CONCLUSION Timely ingestion of Coca-Cola yields significant benefits,including a complete dissolution rate of 100%,a low incidence of gastric ulcers,no need for fragmentation and reduced expenses.展开更多
BACKGROUND With less than 90 reported cases to date,stercoral perforation of the colon is a rare occurrence.Stercoral ulceration is thought to occur due to ischemic pressure necrosis of the bowel wall,which is caused ...BACKGROUND With less than 90 reported cases to date,stercoral perforation of the colon is a rare occurrence.Stercoral ulceration is thought to occur due to ischemic pressure necrosis of the bowel wall,which is caused by the presence of a stercoraceous mass.To underscore this urgent surgical situation concerning clinical presentation,surgical treatment,and results,we present the case of a 66-year-old man with a stercoral perforation.CASE SUMMARY A 66-year-old man with a history of hypertension,hyperlipidemia,and gout presented at the emergency department with lower abdominal pain and a low-grade fever lasting for a few hours.Abdominal computed tomography indicated a suspected bezoar(approximately 7.6 cm)in the dilated cecum,accompanied by pericolic fat stranding,mild proximal dilatation of the ileum,pneumoperitoneum,and minimal ascites.Intraoperatively,feculent peritonitis with isolated cecal perforation were observed.Consequently,a right hemicolectomy with peritoneal lavage was performed.A histopathological examination supported the intraoperative findings.CONCLUSION In stercoral perforations,a diagnosis should be diligently pursued,especially in older adults,and prompt surgical intervention should be implemented.展开更多
Bowel occlusions by bezoars are rare pathologies. They are due to an ob-struction of the intestinal lumen by a solid mass of fruits or undigested vegetable fibers. They are seasonal (wild fruit season from March to Ju...Bowel occlusions by bezoars are rare pathologies. They are due to an ob-struction of the intestinal lumen by a solid mass of fruits or undigested vegetable fibers. They are seasonal (wild fruit season from March to June) in the Sahel Zone. We report a case of small bowel obstruction in a 35-year-old rural man after swallowing a significant amount of wild grapes (Lannea microcarpa). We proceeded to the resection of the occluded ileal segment and performed an ileal terminal ileal anastomosis. There weren’t any complications during the postoperative site.展开更多
BACKGROUND Bezoars can be found anywhere in the gastrointestinal tract.Esophageal bezoars are rare.Esophageal bezoars are classified as either primary or secondary.It is rarely reported that secondary esophageal bezoa...BACKGROUND Bezoars can be found anywhere in the gastrointestinal tract.Esophageal bezoars are rare.Esophageal bezoars are classified as either primary or secondary.It is rarely reported that secondary esophageal bezoars caused by reverse migration from the stomach lead to acute esophageal obstruction.Guidelines recommend urgent upper endoscopy(within 24 h)for these impactions without complete esophageal obstruction and emergency endoscopy(within 6 h)for those with complete esophageal obstruction.Gastroscopy is regarded as the mainstay for the diagnosis and treatment of esophageal bezoars.CASE SUMMARY A 59-year-old man was hospitalized due to nausea,vomiting and diarrhea for 2 d and sudden retrosternal pain and dysphagia for 10 h.He had a history of type 2 diabetes mellitus for 9 years.Computed tomography revealed dilated lower esophagus,thickening of the esophageal wall,a mass-like lesion with a flocculent high-density shadow and gas bubbles in the esophageal lumen.On gastroscopy,immovable brown bezoars were found in the lower esophagus,which led to esophageal obstruction.Endoscopic fragmentation was successful,and there were no complications.The symptoms of retrosternal pain and dysphagia disappeared after treatment.Mucosal superficial ulcers were observed in the lower esophagus.Multiple biopsy specimens from the lower esophagus revealed nonspecific findings.The patient remained asymptomatic,and follow-up gastroscopy 1 wk after endoscopic fragmentation showed no evidence of bezoars in the esophagus or the stomach.CONCLUSION Acute esophageal obstruction caused by bezoars reversed migration from the stomach is rare.Endoscopic fragmentation is safe,effective and minimally invasive and should be considered as the first-line therapeutic modality.展开更多
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The formation of a bezoar is a relatively infrequentdisorder that affects the gastrointestinal system.Bezoars are mainly classified into four types dependingon the material constituting the indigestible mass of thebezoar phytobezoars, trichobezoars, pharmacobezoars,and lactobezoars. Gastric bezoars often cause ulcerativelesions in the stomach and subsequent bleeding,whereas small intestinal bezoars present with smallbowel obstruction and ileus. A number of articles haveemphasized the usefulness of Coca-Cola？ administrationfor the dissolution of phytobezoars. However, persimmonphytobezoars may be resistant to such dissolutiontreatment because of their harder consistency comparedto other types of phytobezoars. Better understanding ofthe etiology and epidemiology of each type of bezoarwill facilitate prompt diagnosis and management.Here we provide an overview of the prevalence, classification,predisposing factors, and manifestations ofbezoars. Diagnosis and management strategies arealso discussed, reviewing mainly our own case series.Recent progress in basic research regarding persimmonphytobezoars is also briefly reviewed.
文摘BACKGROUND Gastric phytobezoars(GPBs)are very common in northern China.Combined therapy involving carbonated beverage consumption and endoscopic lithotripsy has been shown to be effective and safe.Existing studies on this subject are often case reports highlighting the successful dissolution of phytobezoars through Coca-Cola consumption.Consequently,large-scale prospective investigations in this domain remain scarce.Therefore,we conducted a randomized controlled trial to examine the effects of Coca-Cola consumption on GPBs.AIM To evaluate the impact of Coca-Cola on GPBs,including the dissolution rate,medical expenses,ulcer rate,and operation time.METHODS A total of 160 consecutive patients diagnosed with GPBs were allocated into two groups(a control group and an intervention group)through computer-generated randomization.Patients in the intervention group received a Coca-Cola-based regimen(Coca-Cola 2000-4000 mL per day for 7 d),while those in the control group underwent emergency fragmentation.RESULTS Complete dissolution of GPBs was achieved in 100% of the patients in the intervention group.The disparity in expenses between the control group and intervention group(t=25.791,P=0.000)was statistically significant,and the difference in gastric ulcer occurrence between the control group and intervention group(χ^(2)=6.181,P=0.013)was also statistically significant.CONCLUSION Timely ingestion of Coca-Cola yields significant benefits,including a complete dissolution rate of 100%,a low incidence of gastric ulcers,no need for fragmentation and reduced expenses.
文摘BACKGROUND With less than 90 reported cases to date,stercoral perforation of the colon is a rare occurrence.Stercoral ulceration is thought to occur due to ischemic pressure necrosis of the bowel wall,which is caused by the presence of a stercoraceous mass.To underscore this urgent surgical situation concerning clinical presentation,surgical treatment,and results,we present the case of a 66-year-old man with a stercoral perforation.CASE SUMMARY A 66-year-old man with a history of hypertension,hyperlipidemia,and gout presented at the emergency department with lower abdominal pain and a low-grade fever lasting for a few hours.Abdominal computed tomography indicated a suspected bezoar(approximately 7.6 cm)in the dilated cecum,accompanied by pericolic fat stranding,mild proximal dilatation of the ileum,pneumoperitoneum,and minimal ascites.Intraoperatively,feculent peritonitis with isolated cecal perforation were observed.Consequently,a right hemicolectomy with peritoneal lavage was performed.A histopathological examination supported the intraoperative findings.CONCLUSION In stercoral perforations,a diagnosis should be diligently pursued,especially in older adults,and prompt surgical intervention should be implemented.
文摘Bowel occlusions by bezoars are rare pathologies. They are due to an ob-struction of the intestinal lumen by a solid mass of fruits or undigested vegetable fibers. They are seasonal (wild fruit season from March to June) in the Sahel Zone. We report a case of small bowel obstruction in a 35-year-old rural man after swallowing a significant amount of wild grapes (Lannea microcarpa). We proceeded to the resection of the occluded ileal segment and performed an ileal terminal ileal anastomosis. There weren’t any complications during the postoperative site.
文摘BACKGROUND Bezoars can be found anywhere in the gastrointestinal tract.Esophageal bezoars are rare.Esophageal bezoars are classified as either primary or secondary.It is rarely reported that secondary esophageal bezoars caused by reverse migration from the stomach lead to acute esophageal obstruction.Guidelines recommend urgent upper endoscopy(within 24 h)for these impactions without complete esophageal obstruction and emergency endoscopy(within 6 h)for those with complete esophageal obstruction.Gastroscopy is regarded as the mainstay for the diagnosis and treatment of esophageal bezoars.CASE SUMMARY A 59-year-old man was hospitalized due to nausea,vomiting and diarrhea for 2 d and sudden retrosternal pain and dysphagia for 10 h.He had a history of type 2 diabetes mellitus for 9 years.Computed tomography revealed dilated lower esophagus,thickening of the esophageal wall,a mass-like lesion with a flocculent high-density shadow and gas bubbles in the esophageal lumen.On gastroscopy,immovable brown bezoars were found in the lower esophagus,which led to esophageal obstruction.Endoscopic fragmentation was successful,and there were no complications.The symptoms of retrosternal pain and dysphagia disappeared after treatment.Mucosal superficial ulcers were observed in the lower esophagus.Multiple biopsy specimens from the lower esophagus revealed nonspecific findings.The patient remained asymptomatic,and follow-up gastroscopy 1 wk after endoscopic fragmentation showed no evidence of bezoars in the esophagus or the stomach.CONCLUSION Acute esophageal obstruction caused by bezoars reversed migration from the stomach is rare.Endoscopic fragmentation is safe,effective and minimally invasive and should be considered as the first-line therapeutic modality.
