An endoscopic method for removal of duodenal phytobezoars

Saeed, Zahid A.; Rabassa, Alfredo A.; Anand, Bhupinderjit S.

doi:10.1016/s0016-5107(95)70282-2

Cited by 21 publications

(22 citation statements)

References 12 publications

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“…Gastric operations may reduce gastric motor activity and delay gastric emptying. Loss of pyloric function, gastric motility and hypoacidity plays an important role in the formation of disopyrobezoar [6] . Diabetes mellitus and hypothyroidism we r e a l s o r e p o r t e d a s p r e d i s p o s i n g f a c t o r s o f disopyrobezoar formation because they could delay gastric emptying [7] .…”

Section: Case Reportmentioning

confidence: 99%

Huge gastric disopyrobezoar: A case report and review of literatures

Zhang

Yang²,

Fan³

2008

WJG

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after one year of persistent epigastric distention and acid regurgitation, which were uninfl uenced by ingesting food. There were no obvious symptoms of gastrointestinal obstruction, e.g., nausea or vomiting. The patient had a long history of overindulgence of bitter persimmons from childhood without the history of gastric surgery.On physical examination, a solid, movable ellipse mass could be palpated in the left epigastrium and the abdomen was soft. Gastroscopical examination showed a giant brown solid gastric bezoar of 15 cm × 7 cm in size (Figure 1), chronic superficial gastritis as well as two erosions at the corner of the stomach, which were pathologically proven to be chronic superficial active membraneous inflammation. Abdominal computerized tomography revealed a mass-like occupational lesion within the stomach (18 cm long and 7 cm in diameter) with air bubbles retained in its interstices and mottled appearance, compatible with the features of bezoars (Figure 2). The patient was then admitted to the department of gastroenterology of our hospital.On the 3 rd day after admission to hospital, endoscopy (Fujinon EG 250 WR 5, Fuji Photo Optical Company Ltd, Tokyo, Japan) was used to fragment the huge bezoar with a mouse-teeth clamp and snare, but it was unsuccessful to extract the bezoar despite the help of gastric lavage using sodium bicarbonate (NaHCO3) because the bezoar was too hard and big. On the 4 th d, another attempt of endoscopical fragmentation and extraction procedure also failed. On the 5 th day, the patient was transferred to the department of general surgery for operation after two failed attempts in endoscopic fragmentation and removal of the gastric bezoar.Gastrotomy was performed on the patient and a huge grey ellipse bezoar (18 cm × 7.5 cm × 7 cm) was removed from the gastric lumen (Figure 3). A piece of the bezoar obtained during endoscopy was analyzed by infrared spectroscopy, which revealed that 85% of them was composed of tannin and 10% was cellulose, therefore, the bezoar was considered as disopyrobezoar derived from bitter persimmon. The patient was discharged on the 7 th postoperative day. During the 6-month follow-up, the patient did not complain of any discomfort and the two concomitant erosions healed uneventfully on medical therapy shown by another gastroscopy. DISCUSSIONBezoars are classifi ed according to their composition into phytobezoar, trichobezoar (hair), lactobezoar (concentrated AbstractWe 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.

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Section: Case Reportmentioning

confidence: 99%

Huge gastric disopyrobezoar: A case report and review of literatures

Zhang

Yang²,

Fan³

2008

WJG

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“…These include loss of pyloric function, decreased gastric motility as well as acid secretion following gastric surgery, adhesions due to abdominal surgery, inadequate chewing, and excessive consumption of herbal nutrients including high amounts of indigestible fibers. [18][19] Furthermore, delayed gastric emptying, resulting from diabetic neuropathy or hypothyroidism or connective tissue diseases also play a role in its development. 2 In this case the bezoar was a phytobezoar as it was composed of undigested food fibers macroscopically and was microscopically confirmed as of vegetable or plant origin.…”

Section: Discussionmentioning

confidence: 99%

Intestinal Phytobezoar: A Rare Case Report

et al. 2017

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“…Small bowel bezoars are often found in association with gastric bezoars. Primary small bowel bezoars are very rare and almost always present as intestinal obstruction, their most common complication [19]. Hence the clinical symptoms do not differ from those of small bowel obstruction resulting from other causes.…”

Section: Discussionmentioning

confidence: 99%