Diffuse digestive bezoar: a rare and severe complication of enteral nutrition in the intensive care unit (ICU)

Bouwyn, Jean-Paul; Clavier, Thomas; Eraldi, Jean-Pierre; Bougerol, François; Rigaud, Jean‐Philippe; Auriant, I.; Devos, Nicolas

doi:10.1007/s00134-011-2428-5

Cited by 2 publications

(5 citation statements)

References 5 publications

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“…Bouwyn et al[ 11 ] next described a single case of enteral feed bezoar in 2011. Their case was a patient who had been intubated for pneumonia.…”

Section: Discussionmentioning

confidence: 99%

“…The mechanical causes include anatomical changes, use of bulking agents, and EN composition. Anatomical changes resulting from gastric surgery are known to lead to neurohormonal function and pH changes[ 1 , 3 , 5 , 11 ], and such has been suggested to slow gastrointestinal transit and reduce absorption and digestion. With pancreatectomies, the surgery causes a reduction in pancreatic enzymes.…”

Section: Discussionmentioning

confidence: 99%

“…Of note, this has been consistent across the literature. In the majority of cases, the EN showed thickening and in 2 cases, the feed appeared to have become a cast in the bowel[ 6 , 11 ].…”

Section: Discussionmentioning

confidence: 99%

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Gastrointestinal obstruction secondary to enteral nutrition bezoar: A case report

Siddens

Al-Habbal

Bhandari

2020

WJGS

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BACKGROUND Post-operative enteral nutrition via gastric or jejunal feeding tubes is a common and standard practice in managing the critically ill or post-surgical patient. It has its own set of complications, including obstruction, abscess formation, necrosis, and pancreatitis. We present here a case of small bowel obstruction caused by enteral nutrition bezoar. It is the second recorded incidence of this complication after pancreaticoduodenectomy in the medical literature. CASE SUMMARY The 70-year-old female presented to our institution for a pancreaticoduodenectomy (Whipple’s procedure) for pancreatic adenocarcinoma. On day 5 post-operative, having failed to progress and developing symptoms of small bowel obstruction, she underwent a computed tomography scan, which showed features of mechanical small bowel obstruction. Following this, she underwent an emergency laparotomy and small bowel decompression. The recovery was long and protracted but, ultimately, she was discharged home. A literature search of reports from 1966-2020 was conducted in the MEDLINE database. We identified eight articles describing a total of 14 cases of small bowel obstruction secondary to enteral feed bezoar. Of those 14 cases, all but 4 occurred after upper gastrointestinal surgery; all but 1 case required further surgical intervention for deteriorating clinical picture. The postulated causes for this include pH changes, a reduction in pancreatic enzymes and gastric motility, and the use of opioid medication. CONCLUSION Enteral feed bezoar is a complication of enteral feeding. Despite rare incidence, it can cause significant morbidity and potential mortality.

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“…Bouwyn et al[ 11 ] next described a single case of enteral feed bezoar in 2011. Their case was a patient who had been intubated for pneumonia.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Gastrointestinal obstruction secondary to enteral nutrition bezoar: A case report

Siddens

Al-Habbal

Bhandari

2020

WJGS

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“…The diagnosis was made with an abdominal X-ray that showed the stomach filled with calcifications [ 11 ]. A case of a diffuse bezoar in the stomach and small bowel was reported in a patient with legionella pneumonia with adult respiratory distress syndrome [ 12 ]. In this case the bezoar was attributed to the initiation of enteral nutrition during paralytic ileus after surgical treatment of alithiasic cholecystitis, the use of opioids, and the overlap between enteral nutrition and norepinephrine [ 12 ].…”

mentioning

confidence: 99%

“…A case of a diffuse bezoar in the stomach and small bowel was reported in a patient with legionella pneumonia with adult respiratory distress syndrome [ 12 ]. In this case the bezoar was attributed to the initiation of enteral nutrition during paralytic ileus after surgical treatment of alithiasic cholecystitis, the use of opioids, and the overlap between enteral nutrition and norepinephrine [ 12 ]. Also, a small bowel bezoar was reported in a 67-year-old male patient in the postoperative period after gastrectomy with a Roux-en-Y reconstruction and cholecystectomy, with enteral nutrition through a jejunostomy [ 13 ].…”

mentioning

confidence: 99%

Enteral nutrition-related small bowel bezoar: a case report and literature review

Llobera,

Pasquini,

Reberendo

et al. 2023

ait

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Diffuse digestive bezoar: a rare and severe complication of enteral nutrition in the intensive care unit (ICU)

Cited by 2 publications

References 5 publications

Gastrointestinal obstruction secondary to enteral nutrition bezoar: A case report

Gastrointestinal obstruction secondary to enteral nutrition bezoar: A case report

Enteral nutrition-related small bowel bezoar: a case report and literature review

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