A rare cause of mechanical intestinal obstruction: Pharmacobezoar

Erdemır, Ayhan; Agalar, Fatih; Çakmakçı, Metin; Ramadan, Saleem Z.; Baloğlu, Hüseyi̇n

doi:10.5152/ucd.2014.2749

Cited by 9 publications

(8 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Unfortunately, because of its insolubility, this polymer carrier may contribute to bezoar formation. Likewise, bulk-forming agents that treat constipation, such as psyllium, polycarbophil, methylcellulose, etc., may also trigger the formation of pharmacobezoars through their hygroscopic properties [10-12]. Recently, a methadone double pharmacobezoar was reported, causing coma in a drug-addicted male psychiatric patient.…”

Section: Classification Of Bezoarsmentioning

confidence: 99%

Pathophysiological and clinical aspects of the diagnosis and treatment of bezoars

Paschos

Chatzigeorgiadis

2019

aog

106

View full text Add to dashboard Cite

Bezoars are intraluminal conglomerates of indigestible foreign materials that accumulate in the gastrointestinal (GI) tract. They consist of vegetable or fruit fibers, hairs or other substances; accordingly, bezoars are classified as phytobezoars, trichobezoars, pharmacobezoars, etc. Although sometimes asymptomatic, bezoars may cause serious symptoms, such as abdominal discomfort or pain, dysphagia, hematemesis, or even life-threatening entities (GI bleeding, obstruction or perforation). Current technological applications have contributed to the diagnostic and therapeutic approach to these masses, mainly through endoscopic techniques able to diagnose, fragment and extract bezoars, as well as laparoscopic and other surgical modalities that may be used to treat serious complications. Although bezoars were described centuries ago and the term was officially introduced in the mid nineties by Quain, they are still a demanding pathological entity. Their pathophysiology, accurate and prompt diagnosis, as well as successful and minimally invasive treatment, remain under investigation and see continuous progress. Current advances in these challenging areas are discussed in this review, which attempts to present an in-depth study of bezoars along with the well-established modalities and techniques.

show abstract

Section: Classification Of Bezoarsmentioning

confidence: 99%

Pathophysiological and clinical aspects of the diagnosis and treatment of bezoars

Paschos

Chatzigeorgiadis

2019

aog

106

View full text Add to dashboard Cite

show abstract

“…The majority of bezoars are located in the stomach; however, they may be encountered in the whole GIT, including the esophagus and colon. Depending on the material of origin, four different types of bezoars have been described: phytobezoars (hortobezoars), trichobezoars (pilobezoars, hairball), stone-like foreign bodies, and pharmacobezoars (drug-induced)8. There is little knowledge on pharmacobezoars, as there are only nearly 30 published articles on the subject.…”

Section: Discussionmentioning

confidence: 99%

“…There is little knowledge on pharmacobezoars, as there are only nearly 30 published articles on the subject. The majority of pharmacobezoars develop in the stomach8, formed by the anomalous binding of drugs due to alterations in GIT anatomical structure, motility, or secretion. It is thus expected that the most common risk factor is a history of previous gastric surgery9.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Cecum perforation associated with a calcium polystyrene sulfonate bezoar - a rare entity

Fiel

Santos

et al. 2019

J. Bras. Nefrol.

View full text Add to dashboard Cite

Hyperkalemia is one of the most common electrolyte disorders, responsible for a high number of adverse outcomes, including life-threatening arrhythmias. Potassium binders are largely prescribed drugs used for hyperkalemia treatment but unfortunately, there are many adverse events associated with its use, mostly gastrointestinal. Identification of patients at highest risk for the serious complications associated with the current potassium binders, such as colon necrosis and perforation, could prevent fatal outcomes. The authors present a case of a 56-year-old man with secondary diabetes and chronic renal disease that was treated for hyperkalemia with Calcium Polystyrene Sulfonate (CPS). He later presented with acute abdomen due to cecum perforation and underwent ileocecal resection but ultimately died from septic shock a week later. During surgery, a solid white mass was isolated in the lumen of the colon. The mass was identified as a CPS bezoar, a rare drug-mass formed in the gastrointestinal tract that contributed to the perforation. A previous history of partial gastrectomy and vagothomy was identified as a probable risk factor for the CPS bezoar development. Hopefully, the two new potassium binders patiromer and (ZS-9) Sodium Zirconium Cyclosilicate will help treat such high-risk patients, in the near future.

show abstract

“…Rarely, they can form and stop in the stomach and can cause ulcerative lesions, bleeding, or, very infrequently, obstruction [5]. Bezoars are classically defined as an intraluminal solid foreign body, made of different indigestible materials [6–9]. There are four different types, named after the material from which they are composed: trichobezoars, resulting from the ingestion of hair; phytobezoars, made of vegetables and indigestible fruit fibers; lactobezoars, which are formed from milk curd; and pharmacobezoars, caused by drugs and medications [6, 10].…”

Section: Introductionmentioning

confidence: 99%

A rare case of a double phytobezoar causing gastric and jejunum obstruction in an adult man: a case report

et al. 2016

View full text Add to dashboard Cite

BackgroundBezoars are an uncommon cause of mechanical intestinal occlusion. There are four different kinds of bezoars: phytobezoars, made of vegetables and fibers; trichobezoars, resulting from the ingestion of hair and frequently an expression of psychiatric disorders; lactobezoars, which are formed of milk curd; and pharmacobezoars, caused by drugs and medications. Symptoms are classically indistinguishable from one another and from more common causes of intestinal occlusion, so it can be difficult to establish a correct diagnosis in order to apply the correct treatment. We present a rare case of two different phytobezoars causing intestinal occlusion (gastric and jejunal). We also describe the correct techniques for making a correct and fast diagnosis of occlusion caused by phytobezoars, and the possible conservative and operative treatments.Case presentationWe present the case of a double phytobezoar that was surgically treated with a double enterotomy. Our patient was a 68-year-old Caucasian man with a medical history of hypertension, a previous open appendectomy, and open repair of a perforated gastric ulcer. He was admitted with a 5-day history of abdominal pain located in his upper quadrants along with vomiting. After a preoperative examination, he was taken to the operating room. He was discharged in a good clinical condition 11 days after surgical intervention. A physical examination at 6 months demonstrated our patient was in good health.ConclusionsDiagnosing bezoars is difficult because of their rarity. However, they must be taken into consideration in a differential diagnosis because their treatment is not always surgical. In fact, it may be conservative in many cases and a correct diagnosis will guide towards the correct therapy.

show abstract

A rare cause of mechanical intestinal obstruction: Pharmacobezoar

Cited by 9 publications

References 5 publications

Pathophysiological and clinical aspects of the diagnosis and treatment of bezoars

Pathophysiological and clinical aspects of the diagnosis and treatment of bezoars

Cecum perforation associated with a calcium polystyrene sulfonate bezoar - a rare entity

A rare case of a double phytobezoar causing gastric and jejunum obstruction in an adult man: a case report

Contact Info

Product

Resources

About