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Gastric bezoar is an uncommon complication following Roux-en-Y gastric bypass (RYGBP). We report two cases of bezoar formation that occurred following laparoscopic RYGBPs. In both cases, the patients presented with abdominal pain, nausea, and "frothy" vomiting. The patients were successfully treated by endoscopic fragmentation and removal of the bezoar.
Gastric bezoars were observed after esophageal variceal injection of polidocanol in 5 of 56 patients with alcoholic cirrhosis treated by endoscopic sclerosis. We suggest that endoscopic sclerotherapy could have induced a transient vagal injury resulting in delayed gastric emptying and subsequent bezoar formation. Although the volume of sclerosant (25-35 ml per session) and the length of the injector needle (4 mm) were the same in all patients, two reasons could explain the occurrence of bezoars in these five patients: a deeper injection of sclerosant, and a worsening of a preexistent vagal neuropathy due to diabetes mellitus and/or alcoholism.
Bezoars are an uncommon cause of acute gastric outlet obstruction. To our knowledge, this is the first report of a bezoar formed around a gallstone that migrated to the stomach via a cholecystogastric fistula. Our patient was a 42-year-old African American woman with long-standing type 2 diabetes. We suspect that diabetic diathesis was the major factor responsible for producing the pathologic derangement of the gallbladder and stomach, which led to development of the bezoar and serious complications.
Bezoars are concretions of foreign materials that are created in the intestinal tract of various animals and humans. They have been known to western medicine since ancient times, when they were used for countering and preventing poisoning. In modern times bezoars were described as an unusual cause for various gastrointestinal symptoms. Trichobezoars are an infrequent form of bezoar, formed from ingested hair. We present a case of a trichobezoar, which appeared as a large abdominal mass, with gastric bleeding, ulceration and perforation. As in most previously reported cases, the diagnosis was not made on clinical grounds prior to imaging studies.
A case of gastric phyto-mucous bezoar++ in an edentulous patient with chronic gastritis is reported. The effective medical treatment consisted of partial gastroscopic bezoar crumbling, gastric lavage with 1% sodium bicarbonate solution, and endoscopic removal of residual bezoar. The pathogenesis, symptoms, and treatment of gastric phytobezoars are discussed.
Bezoars are the uncommon result of the ingestion of indigestible or poorly digested substances, which form a solid mass within the gastrointestinal tract. They are classified based on their content and include phytobezoars (plant fibers), trichobezoars (hair), and lactobezoars (milk curds). They may occur in combinations like trichophytobezoars, and can result from virtually anything capable of forming concretions within the gastrointestinal tract, including medications. They are found mainly in the stomach and are rare in the colon. Bezoars are uncommon in children. We report the rare case of a sunflower-seed bezoar impacted at the anal verge in a 6-year-old boy who presented initially with acute gastroenteritis. He required removal of the impaction under sedation.
Bezoars are concretions of stagnant swallowed material in digestive tract. The most frequent are trichobezoars made of hair and phytobezoars composed of undigestible fruits and vegetables fibers. We report a case of a 24-year-old female patient who presented in emergency with an acute peritonitis due to a gastric perforation on bezoars. Gastrotomy, extraction of bezoars, gastric stitching and peritoneal lavage were performed. Post operative period was uneventful. A new careful interrogation into the patient's previous habits found glue-eating custom during the four last years.
The authors report a retrospective study of 10 cases of gastric and small bowel bezoars. There was one gastric trichobezoar diagnosed by an abdominal mass and 9 small bowel obstruction due to phytobezoars. All patients underwent surgery: the gastric trichobezoar was removed through a gastrotomy; small bowel bezoars were treated either by enterotomy (n = 3), fragmentation (n = 5) or bowel resection (n = 1). Non operative treatment is efficient in gastric phytobezoars. Surgery is advisable for trichobezoars and small bowel bezoars. Prevention is main and patients who have gastric surgery must be alarmed from consumption of cactus in our country Tunisia.
The authors report a case of a 3-year-old boy with a gastric and ileal bezoar, in whom severe anaemia and tumor in the epigastrium were the main symptoms. Bezoars are rare foreign bodies of the gut. They contain swallowed hair, different fibres, seeds, nutshells, sweets or drugs. The group of risk factors for bezoar formation includes anatomical defects, motoric disorders of the digestive tract, type of prescribed drugs and other coexisting chronic diseases. Most cases need surgical treatment.
This case report describes an 11-year-old boy with a known esophageal bezoar admitted to surgery for esophagogas-troduodenoscopy with biopsy and possible removal of the bezoar. On induction, a copious amount of fluid and solid food particulate was noted in the posterior oropharynx, interfering with immediate intubation. After clearing of the oropharynx, the patient was intubated. A bronchoscopy revealed aspirated food materials. A stat intraoperative consultation was initiated for rigid bronchoscope with bronchial suctioning to clear aspirated undigested food particles and an esophageal scope to remove the bezoar mass in pieces. Postoperatively, the parents were notified that the jejunal mass would require further workup with possible surgical removal.
This paper reports the successful experiences of in vitro and in vivo studies on endoscopic fragmentation of gastric bezoars using a laser-ignited mini-explosive device. This new technique has been used clinically in 31 patients with gastric bezoars since January 1988. All patients were completely cured without any complication. The relationship between gastric bezoars and ulcers, and the technique of treatment were discussed.
A 49 year old woman presented with fever. Blood chemistry showed cholestasis. Sonography and abdominal computed tomography showed a dilated biliary tract and a fluid collection in the head of the pancreas. A large, interposed, diverticulum of the second duodenum, filled with a bezoar, was documented by duodenoscopy. The bezoar was fragmented and removed by biopsy forceps. Retrograde visualization of the common bile duct then showed a normal biliary tree with good clearance of contrast material. The ulterior course was uncomplicated. This is the second reported case for cholestasis due to an intradiverticular bezoar in an interposed duodenal diverticula. Diagnosis and treatment were made by duodenoscopy.
A gastric bezoar complicated the postoperative course of three children following successful hepatic transplantation. Two patients had evidence of extremely erratic absorption of the cyclosporine (CSA) used for immunosuppression. Gastric bezoars usually occur in patients with gastric dysmotility and/or patients ingesting poorly digestible material. Although several factors may contribute to bezoar formation after hepatic transplantation, a major predisposing factor may be the administration of the large quantities of olive oil required for solubilization of CSA.
The experience of breaking gastric bezoars endoscopically with a laser ignited mini-explosive head was reported. After successful application of this technique in vitro and in experimental animals, we began to use it clinically in January 1988. In a period of more than four years, we treated 100 cases of gastric bezoars, 80 cases being male and 20 female, aged from 5 to 65 years. 70 cases were cured after one treatment, 24 after two and the remaining 6 cases after three times of treatment. The cure rate was 100%. Except one case complicated with gastric perforation, no other complications were observed. The etiology and prevention of gastric bezoars, as well as the new method and experience in treating this disease were discussed.
Fungal urinary tract infections are due to candida albicans as first responsible germ. This sporulated oval fungus divides itself by gemmation and produces pseudohyphas when it is spread in culture mediums, organic tissues or their exudates. The most frequent predisposing factor is diabetes mellitus. Others predisposing factors are: long antibiotic administration, corticoids, immunosuppressors, neoplasias, neurogenic bladder, and catheter or foreign bodies into the urinary tract. Bezoar formation is a rare complication that sometimes produces obstructive uropathy. Although Candida albicans is the most frequent observed germ in bezoars, Candida tropicalis, Penicillium, Aspergillus, Mucor y Turolopsis have been found as well. We present the case of a diabetic patient with a bilateral bezoar formation into the upper urinary tract due to Candida albicans. Clinical features, diagnosis and treatment are described emphasizing in the are bilateral onset.
We report herein the rare case of a 26-year-old woman who developed a small-bowel obstruction caused by a medication "bezoar" or enterolith, following the long-term ingestion of magnesium oxide cathartics for constipation. Medication bezoars resulting from laxatives or cathartics have rarely been reported and we were only able to find two other such cases in the literature.
Systemic candidiasis with renal involvement is a well recognised complication of intensive care in premature newborns. However, the development of reversible obstructive oliguric acute renal failure has not been well documented. We report a premature infant who developed anuria associated with bilateral candidal bezoar formation in the renal collecting system. The sonographic appearance of the renal fungus balls is described. Treatment by surgical removal of the bezoars, open placement of nephrostomy tubes and intravenous antifungal therapy resulted in apparent complete recovery.
An esophageal bezoar occurring in a young patient without esophageal abnormality is described. The history of severe progressive dysphagia following forceful vomiting and presence of a gastric ulcer suggest that the esophageal bezoar might have originated in the stomach.