Esophageal and small bowel obstruction by occupational bezoar: report of a case

Pitiakoudis, Michail; Tsaroucha, Alexandra; Mimidis, Konstantinos; Constantinidis, Theodoros C.; Anagnostoulis, Stavros; Stathopoulos, George; Simopoulos, Constantinos

doi:10.1186/1471-230x-3-13

Cited by 25 publications

(23 citation statements)

References 4 publications

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“…12 Our patient had asymptomatic gastric bezoar, which failed endoscopic removal due to the large size. 14 In conclusion, this case illustrates the diagnostic and therapeutic value of laparoscopy in well-selected patients with small intestinal obstruction. The three most commonly used enzymes are N-acetylcysteine, papain, and cellulase.…”

Section: Discussionmentioning

confidence: 66%

Laparoscopic-assisted Management of Small Bowel Obstruction Due to Phytobezoar

Ganpathi

Cheah²

2005

Surgical Laparoscopy, Endoscopy & Percutaneous Techniques

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Laparoscopy is gaining increasing acceptance for diagnosis and treatment of selected cases of small bowel obstruction. We describe a laparoscopic-assisted procedure used for the treatment of small bowel obstruction caused by a bezoar. A 51-year-old man presented with acute small intestinal obstruction. He had no history of previous abdominal surgery. Diagnostic laparoscopy confirmed a distal ileal obstruction due to an enterolith (bezoar). A limited abdominal incision allowed enterotomy and removal of the obstructing bezoar. Gastroscopy performed a month later showed gastric bezoars which could not be removed endoscopically. Instead, cellulase, a hydrolytic enzyme, was used successfully to treat the condition.

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Section: Discussionmentioning

confidence: 66%

Laparoscopic-assisted Management of Small Bowel Obstruction Due to Phytobezoar

Ganpathi

Cheah²

2005

Surgical Laparoscopy, Endoscopy & Percutaneous Techniques

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“…Cellulase is responsible for the hydrolysis of the β-1,4glycosidic bonds in cellulose (a linear homo-polysaccharide composed of D-glucopyranose units), lichenin (a major polysaccharide component of Iceland moss, Cetraria islandica, composed of β-D-glucopyranose units linked in a linear manner by β-1,4and β-1,3-glycosidic bonds) (Chandae et al, 1957;Peat et al, 1957;Pitiakoudis et al, 2003;Bala et al, 2008) and in cereal beta-D-glucans. Cellulase is an enzyme complex consisting of at least three components generally classified by their hydrolysing functions into the termites secrete an enzyme that hydrolyses cellulose, while ruminants are able to hydrolyse cellulose and utilise the glucose produced because the symbiotic bacteria in their rumen secrete cellulase(s) (Conn and Stumpf, 1976).…”

Section: Introductionmentioning

confidence: 99%

Characterization of a cellulase from the haemolymph of the giant African snail (Archachatina marginata)

Sanya

Kayode²,

Afolayan³

2012

Afr. J. Biotechnol.

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The giant African snails (Archachatina marginata) are herbivorous tropical gastropods. They are commonly located in areas littered with decaying vegetable matters which they feed on. When the haemolyph of this organism was passed through Sephadex G-200, the resin was digested. The ability of snails to digest vegetable matters and the digestion of Sephadex G-200 resin by the haemolyph led to the suspicion of the presence of cellulase in snail haemolyph. Cellulase from haemolyph of the giant African snail was purified to homogeneity by a combination of gel filtration on BioGel P-300 and ionexchange chromatography on DEAE-Sephadex. The homogeneity of the pure enzyme was adjudged by polyacrylamide gel electrophoresis in the absence and presence of sodium dodecyl sulphate. The subunit molecular weight was 16,875±1,556 daltons and the apparent molecular weight as determined by gel filtration was 52,000 daltons. Thus, the enzyme is at least a dimer. The enzyme had a specific activity of 1359.09 units/mg of protein. The Michaelis-Menten constant (K m) for carboxymethyl (CM)cellulose was 5.17± 0.74 mg/ml and the maximum velocity (V max) was 1067±195 units/ml. The enzyme did not degrade salicin, cellobiose and o-nitrophenyl-β-D-glucopyranoside. In addition, its activities towards filter paper and cotton wool were insignificant compared with its activity towards CM-Cellulose. Linamarin was found to inhibit the action of the enzyme to about 18%. The high specificity for CMcellulose and the rapid decrease in the viscosity of CM-cellulose suggests that the enzyme is likely an endoglucanase.

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“…Most of the published cases present critically ill patients on enteral feeding via nasogastric tube (7). There are reports of bezoars formed after vagotomy and or pyloroplasty, but the bezoars were formed in the stomach (8). The main reason for formation of bezoars is presumed to be motility disorders-including achalasia, diffuse esophageal spasm, progressive systemic sclerosis, GuillainBarre syndrome and myasthenia gravis (2).…”

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confidence: 99%