Gastrointestinal Bezoars

Abstract

We present 60 patients with gastrointestinal bezoars in the time from 1971 to 1988 inclusive. Their aetiological, diagnostic and therapeutic circumstances were analysed, as well as any bezoar relapses. From the aetiological point of view, most of our patients had previously undergone gastric surgery (78.3 %, of which 62.1 % had received bilateral truncal vagotomy plus a gastric drainage technique). As to diagnosis, 78.3% of our patients began as cases of intestinal obstruction through obturation, and diagnosis was made by means of simple abdomen radiology. In 21.7%, gastric symptomatology was indicated by the presence of a gastric bezoar, with endoscopy being the fundamental exploratory technique used. The most frequently used surgical technique in the cases of intestinal obstruction was enterotomy and removal of the bezoar. Of the gastric bezoar patients (n = 13), 5 received conservative treatment while the remaining 8 underwent surgery with gastrotomy. There were 10 bezoar relapses (16.6%) in our series, who required reoperation.

Relapsing massive metal bezoar: a case report

“…Other bezoars occur as a complication of gastric motility, usually prior gastric surgery such as vagotomy, leading to reduced gastric acidity; gastric stasis and loss of pyloric function; peptic ulcer disease/stenosis; chronic gastritis; Crohn's disease; carcinoma of the stomach, duodenum, or pancreas; dehydration and hypothyroidism [10]; diabetic patients with neuropathy or myotonic dystrophy [11]. Also to be considered is the fact that certain medications that decrease GI motility, such as anticholinergic agents, ganglionic blocking agents, and opiates, may also give rise to a bezoar [10].…”

“…Once the obstruction occurs, surgery is the only way to solve the problem. Frequently, synchronous bezoars are found in the stomach or other areas of the gastrointestinal tract; therefore it is mandatory to carry out a thorough exploration of the small intestine and colon [11] to avoid recurrence of intestinal obstruction due to a retained bezoar. After discharge, recurrence has been reported in up to 14% of cases, especially in patients with psychiatric disturbances and with previous gastric surgery [3].…”