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At least 19 recordsLinked to original sources

Yeast bezoar formation following gastric surgery.

Yeast bezoar seems to be a relatively common late complication after various gastric operations. The incidence of bezoar depends decisively on the nature of the operation. Vagotomy in particular is conducive to the formation of a bezoar. Vagotomy + Billroth I resection proveded the most propitious conditions for the growth of yeast, for every one-half of the patients in this group developed a bezoar. Yeast bezoars usually appear within a year of the operation. The majority disappear during the first follow-up year, many without any therapy. However, in some cases the bezoar was a rather inconvenient late complication of gastric surgery and one that gave symptoms. It is difficult to draw any definite conclusions concerning the effect of therapy on the disappearance of the bezoar. We used gastric lavage and antimycotics as well as substances that increase gastric acidity. There is still no known method of preventing the formation of yeast bezoars. In the present consensus, a change in the acid conditions and disturbed gastric motility postoperatively are conducive to the formation of a bezoar.

Adult

[Treatment of the gastric bezoar by endoscopy].

This paper deals with our experiences in a group of patients with gastric bezoars who were treated endoscopically. A group of 7 patients, 5 women and 2 men, from 41 to 62 years of age, with the diagnosis of bezoar was studied. In 6 cases both the clinical and roentgenographic diagnosis was bezoar; in one case the diagnosis was not established before endoscopy. Endoscopic studies were performed to confirm the diagnosis and for treatment. The bezoars were fragmented, under endoscopic observation, with the biopsy mechanism and, after removal of the endoscope, gastric lavage was done through a 12 mm. tube for removal of the bezoar fragments. Postendoscopically all patients were given metoclopramide and new films were take at one week. Confirmation of complete removal of the bezoars was also obtained by subsequent endoscopic control. No complications were observed in any of the patients. We propose that endoscopic removal of bezoars is the treatment of choice because it lowers morbility, mortality and eliminates the need for surgery as well as lowering hospitalization time.

Adult

Gastric surgery and bezoars.

We present a series of 56 patients with gastrointestinal bezoar following previous gastric surgery for gastroduodenal peptic ulcer. The following parameters were studied: factors predisposing to bezoar formation (type of previous surgery, alimentation, and mastication), form of clinical presentation, diagnostic tests, and treatment. A bilateral truncal vagotomy plus pyloroplasty had been performed previously on 84% of patients, 44% revealed excessive intake of vegetable fiber, and 30% presented with bad dentition. The most frequent clinical presentation was intestinal obstruction (80%). This was diagnosed mainly by clinical data and simple abdominal radiology. The main exploratory technique for diagnosing cases of gastric bezoar was endoscopy. Surgery is necessary for treating the intestinal forms, and one should always attempt to fragment the bezoar and milk it to the cecum, reserving enterotomy and extraction for cases where this is not possible. The small intestine and stomach should always be explored for retained bezoars. Gastric bezoars should always receive conservative treatment, endoscopic extraction, and/or enzymatic dissolution; gastrotomy and extraction should be performed when this fails.

Adult

Gastric bezoars. A technique of endoscopic removal.

Gastric bezoar formation is an uncommon sequela of gastroduodenal surgery or unusual eating habits. Because they generally produce severe symptoms, their removal is always necessary. Previously, this required surgical extirpation or slow enzymatic dissolution. We present here an endoscopic procedure for bezoar removal utilized successfully in five patients with vegetable-mucus bezoars. This technique employs a jet spray of water under direct vision to mechanically disrupt the bezoar, which may then be removed using a large gastric lavage tube. This procedure is simple, safe, and rapid and is therefore recommended as an alternative to surgical removal or enzymatic dissolution of gastric bezoars.

Bezoars

Fungal bezoars of the upper urinary tract.

We report our experience with 6 cases of upper tract fungal bezoars involving 9 renal units-3 bilateral aspergillomas and 3 Candida bezoars. The Aspergillus bezoars were notably more morbid: 2 patients required nephrectomy after failure of medical therapy, whereas the 3 unilateral Candida bezoars all resolved with medical therapy and endourological access. In 1 patient whose aspergilloma was resistant to amphotericin B the investigational drug itraconazole proved effective. These opportunistic infections, seen increasingly in immunocompromised patients, can present a difficult management problem. A combined approach is necessary, including medical therapy with topical and systemic antifungal agents, and endourological access for extraction, lavage and debulking.

Adult

Treatment of a gastric bezoar by extracorporeal shock wave lithotripsy.

A bezoar of the stomach was diagnosed by X-ray and endoscopy in an 8-year-old boy who presented with intermittent dull epigastric pain. Attempts at endoscopic extraction failed because of the size and hardness of the bezoar. Extracorporeal shock wave lithotripsy was therefore applied using ultrasound to locate the bezoar. Disintegration of the bezoar and spontaneous evacuation of the fragments was achieved.

Bezoars

Management of persimmon bezoars (diospyrobezoars).

Since 1946, 20 men and one woman aged 40 to 76 years (average 57) were operated upon for complications of diospyrobezoars. Shortly after eating persimmons, 11 (52.4%) had severe abdominal cramping, anusea, vomiting, and pyrexia. Twelve of 17 (70.9%) with gastric bezoars had hematemesis or melena caused by an associated gastric ulcer, while five (29.1%) had only moderate dyspepsia. In four (19.1%), the bezoar had lodged in the ileum, causing obstruction. Enzymatic therapy is indicated in those with minor symptoms. Gastrotomy or gastrotomy with bezoar removal and wedge resection of the gastric ulcer is recommended when enzymatic therapy fails, or when there is gastric outlet obstruction or marrise hemorrhage. Emergency exploration with removal is necessary when the persimmon bezoar causes ileal obstruction.

Adult

Cecal vitamin bezoar formation inducing abdominal discomfort.

OBJECTIVE: To document a case of cecal lecithin-vitamin B12 bezoar formation inducing abdominal discomfort. DESIGN: Case study. SETTING: 500-bed, community teaching hospital. PATIENT: 81-year-old man with a history of multiple abdominal surgeries who presented with a chief complaint of abdominal pain. Flat plate X-ray of the abdomen revealed multiple capsule-shaped objects lodged in the cecum. INTERVENTIONS: Catharsis with bisacodyl, magnesium citrate, NaCl 0.9%; dissolution with heated, dilute barium administered rectally in conjunction with external manipulation; laparotomy. MAIN OUTCOME MEASURES: None planned; dissolution or transit of bezoar through gastrointestinal tract desired outcome. RESULTS/DISCUSSION: Classification of bezoars and treatment discussed in relation to this case report. CONCLUSIONS: Medicinal agents have been implicated in bezoar formation. Treatment options have included: cathartics, heated solvent enemas, and external manipulation and surgery.

Abdominal Pain

[A case of phyto-mucous bezoar of the stomach].

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.

Aged

Endoscopic lithotripsy of gastric bezoars using a laser-ignited mini-explosive device.

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.

Adolescent

[Cholestasis caused by an intradiverticular bezoar. Endoscopic treatment].

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.

Bezoars

Oesophagus bezoar diagnosed and removed endoscopically.

The authors describe the rare case of bezoar in the oesophagus. Their patient was sent to their Clinics with a diagnosed oesophageal tumor. The exact diagnosis was established by endoscopical examination. The bezoar was removed by endoscope, therefore, an operation was not necessary.

Bezoars

Compositional data on some Persian bezoars.

Fourteen Bezoars from Persia, used in past times and even to-day as a medicine or as a health-preserving precious tone, are examined. Among the concretions ellagic acid prevails. Some are bile pigmented or calcite stones. Other bezoars are mineral substances or artifacts.

Animals

Postgastrectomy bezoars.

Sixteen cases of postgastrectomy bezoars were diagnosed and treated in the period of five years. Various mechanisms of their information, symptomatology and therapy are discussed. We believe postgastrectomy bezoars are relatively frequent but often missed entities. Considering the relative frequency of this entity and ease of therapy, this condition should not be missed if one is aware of its existence.

Adult

Bezoars: a special cause of ileal obstruction in mentally retarded patients.

Abdominal symptoms in mentally retarded patients may pose difficult diagnostic problems due to an unreliable history of disease and incooperation of the patients. The case histories are presented of three patients with bezoars in the ileum. Delayed diagnosis and signs of peritonitis necessitated emergency surgery. All patients could successfully be treated by small bowel resection and primary anastomosis. In mentally retarded patients with abdominal pain a bezoar must be considered.

Adolescent

[Gastroparesis diabeticorum and bezoar (author's transl)].

Gastroparesis diabeticorum has been isolated by Kassander in 1958. Since that time, 65 well documented cases have been published. Very often the patients are asymptomatic and the disorder is discovered by an occasional X-ray examination of the G-I tract. But, sometimes, the diabetes of these patients becomes brittle and they loose weight; bezoar, gastroplegia and hemorrhages may occur. We report two additional cases with severe undernutrition and bezoar. The gastroparesis may be related to a vagal neuropathie. The treatment is disappointing; metoclopramide gives the best improvement.

Adult

[The physician at wit's end; a bezoar].

The case is described of a three-year-old Moroccan girl with iron deficiency anaemia and a bezoar resulting from trichotillomania and trichophagy leading to a slowly developed obstruction ileus. Causes, symptoms and treatment of the various forms of bezoar are discussed.

Bezoars

[Bezoars in childhood].

Hospital Infantil de México reports 13 cases of bezoars out of which, 12 were trichobezoars and one fitobezoar. Bezoars are uncommon, but they must be known by the pediatrician as well as by the children surgeon in order to be able to reach a diagnosis and give the treatment. A complete review of the main points is given.

Bezoars