Etiological aspects of intragastric bezoars and its associations to the gastric function implications

Abstract

Rationale:Intragastric bezoar is a stony mass found trapped in the stomach, though it can occur in other locations of the gastro-intestinal tract. The etiology of intragastric bezoar is multifactorial, includes certain risk factors and predisposing factors such as coexisting medical disorders, anatomic abnormalities, and gastric motility disorders, which contribute to the development of intragastric bezoar.Patient concerns:In this report, we present a rare case of intragastric bezoar with epigastric pain after prolonged consumption of jujubes. To our knowledge, this is the first case of intragastric bezoar to be reported after jujubes ingestion.Diagnoses:An upper gastrointestinal (GI) endoscopy performed which revealed an 8 × 5-cm intragastric diospyrobezoar with an adjacent necrotic pressure ulcer of size 0.8 × 0.5-cm without signs of bleeding.Interventions:For therapeutic intervention, Coca-Cola ingestion and lithotripsy were applied.Outcomes:The therapeutic course was uneventful. There was no recurrence during 1-year follow-up.Lessons:In our literature, jujube emerged as a new player. A bezoar composed of unripened fruit content in the stomach, could be the cause of chronic abdominal pain, dyspepsia, gastric reflux or heartburn. Moreover, this study provides a detailed overview of recently published literature regarding intragastric manifestations of bezoar, etiological factors, diagnostic and therapeutic approaches.

Óbito Por Negligência No Tratamento De Dermatite Atópica: Relato De Caso

“…Além dos sinais clínicos descritos no presente caso, Couceiro et al 2016, Finale et al, (2018) e Khan et al, (2018), ainda relatam outras complicações comuns como perfuração, obstrução e sinais inespecíficos como dor abdominal, náuseas, vômito, hematêmese, anorexia, anemia, melena e halitose. Portanto o tamanho do corpo estranho, no interior do estômago, do cão deste estudo, impossibilitava a ingestão de alimentos e dificultava o consumo de água, condição que ocasionou em desnutrição e desidratação.…”

“…A ingestão excessiva de pelos e/ou cabelos (tricofagia) é uma condição que pode levar à formação de tricobezoares, sendo estes mais frequentemente encontrados no estômago. O tricobezoar costuma causar obstrução total ou parcial do trato gastrointestinal devido à formação de uma massa complexa e endurecida, podem, ainda, estender-se para o intestino, fato denominado de síndrome de Rapunzel (PÉREZ et al, 2014;COUCEIRO et al, 2016;FINALE et al, 2018;KHAN et al, 2018).…”

Upper Gastrointestinal Manifestation of Bezoars and the Etiological Factors: A Literature Review

“…Bezoars are congregations or compact masses that formed by the accumulation of matter, especially nonedible materials, including high-fiber vegetable diet, hair, and certain pharmaceutical agents. They are found more frequently in the stomach in patients with normal or abnormal gastric function or in patients with poor gastric peristalsis resulting in delayed gastric draining and other associated disorders [1, 2].…”

“…The majority of gastric bezoars are found to be present in adolescents and young ladies with a history of pica, predominantly psychiatric disorders. In contrast to adults, the majority of gastric bezoars are associated with gastroparesis, anatomical abnormalities, and former gastric surgeries that reduced gastric motility and ultimately resulting in delayed stomach emptying [1].…”

“…The most common clinical presenting symptoms in patients with gastric bezoars include nausea and vomiting, epigastric pain, dyspepsia, and weight loss [1, 3]. They can also be discovered accidentally in asymptomatic patients who undergo upper gastrointestinal (GI) endoscopic evaluation for other indications.…”