Gastrointestinal phytobezoar following bariatric surgery: Systematic review

Ben-Porat, Tair; Sherf-Dagan, Shiri; Goldenshluger, Ariela; Yuval, Jonathan B.; Elazary, Ram

doi:10.1016/j.soard.2016.09.003

Cited by 53 publications

(75 citation statements)

References 42 publications

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“…2 Specific case reports of bezoar complications are available to date only following LRYGB and LAGB operations, but not following LSG. 4 To the best of our knowledge, this is the first case reports of a phytobezoar complicating LSG surgery. The lack of reports of bezoar occurrence after LSG may have several reasons; anastomotic stricture seems to play a key role in bezoar formation post gastrointestinal surgeries.…”

Section: Ben-porat T Et Al Int Surg J 2017 May;4(5):1803-1805mentioning

confidence: 77%

“…Specific case reports of bezoar complications are available to date only following LRYGB and LAGB operations, but not following LSG. 4 We present the first 2 cases, to the authors' knowledge, of phytobezoars occurrence post LSG.…”

Section: Introductionmentioning

confidence: 95%

“…Anatomic complications following LRYGB, even if appropriately treated, may predispose patients to develop bezoars. 4 In addition, LSG is a relatively new bariatric procedure, while bezoar is a rare late post-operative complication and the interval between surgery and bezoars detection may be many years. 1,3 Thus, even being a rare late complication, bezoars should be suspected in LSG patients presenting with obstructive symptoms during the late period post-surgery.…”

Section: Ben-porat T Et Al Int Surg J 2017 May;4(5):1803-1805mentioning

confidence: 99%

“…Eating habits effect the formation of a bezoar and diet modifications according to the nutritional counselling given after a gastric surgery is the best known prevention method against a bezoar formation. 4,5 Guidelines include proper chewing of food, plenty of liquids, keep oral hygiene and avoidance of excessive consumption of high fiber food. 6 We recommend prompt endoscopic intervention to relief the obstruction before parts of the bezoar may migrate to the small bowel, necessitating operative intervention.…”

Section: Ben-porat T Et Al Int Surg J 2017 May;4(5):1803-1805mentioning

confidence: 99%

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Phytobezoar: a rare late complication following laparoscopic sleeve gastrectomy surgery

et al. 2017

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Case reports of bezoar after bariatric surgery are available to date only following Roux-en-Y gastric bypass (RYGB) and laparoscopic adjustable gastric banding (LAGB), but not following laparoscopic sleeve gastrectomy (LSG). Presented here is the first case reports of phytobezoars occurrence post LSG. Two case reports are presented. The mechanisms involved and the therapeutic implications are discussed. Case 1: A 41-year-old woman with a body mass index (BMI) of 45 kg/m2 underwent LSG surgery. Seven months postoperatively she developed significant vomiting and an upper GI gastrografin swallow study revealed a gastric bezoar, confirmed by an esophagogastroduodenoscopy (EGD). The bezoar was broken up and removed with the endoscope. Case 2: A 34-year-old woman with initial BMI of 42.7 kg/m2 was readmitted 5 years post LSG due to reflux accompanied with epigastric pain, vomiting, dysphagia and constipation. An upper GI gastrografin swallow study revealed esophageal dilatation. EGD showed a gastric phytobezoar 3x4cm size, removed by the endoscope. The lack of reports on bezoar occurrence after LSG may be related to the higher rates of stricture reported for LRYGB procedure comparing to LSG. In addition, LSG is a relatively new bariatric procedure, and the interval between surgery and detection of bezoars may be many years later. Thus, even being a rare late complication, bezoars should be suspected in LSG patients presenting with obstructive symptoms during the late post-surgery period. We recommend prompt endoscopic intervention to relieve the obstruction before parts of the bezoar migrate to the small bowel, necessitating operative intervention

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Section: Ben-porat T Et Al Int Surg J 2017 May;4(5):1803-1805mentioning

confidence: 77%

Section: Introductionmentioning

confidence: 95%

Section: Ben-porat T Et Al Int Surg J 2017 May;4(5):1803-1805mentioning

confidence: 99%

Section: Ben-porat T Et Al Int Surg J 2017 May;4(5):1803-1805mentioning

confidence: 99%

See 2 more Smart Citations

Phytobezoar: a rare late complication following laparoscopic sleeve gastrectomy surgery

et al. 2017

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“…Our patient had two major risk factors for the development of a bezoar: a history of gastric bypass surgery and a predilection for consuming her own hair. Patients who have had gastrectomies are at higher risk of developing bezoar because these patients often suffer from gastric motility disorders, achlorhydria and loss of pyloric function 14. Our case is unique because this patient ingested a clip along with her hair, which may have been a nidus for the development of the trichobezoar.…”

Section: Discussionmentioning

confidence: 93%

Endoscopic shaving of hair in a gastric bypass patient with a large bezoar

et al. 2017

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Trichotillomania can be associated with the formation of trichobezoars (hair ball) usually located in the stomach. Trichobezoars may lead to complications including bowel obstruction, and perforation. Patients with a history of diabetes, certain psychiatric disorders, prior gastric surgery and poor mastication ability are at an increased risk of developing bezoars. We are presenting a case of patient who suffered from a large, recurrent trichobezoar, who had a history of gastric bypass surgery as well as trichotillophagia. The endoscopic method used to remove the large bezoar will also be discussed. We have reviewed the cases published, in which patients developed bezoars after undergoing gastric bypass surgery. The purpose of this study is to raise awareness among clinicians that patients with certain psychiatric issues who had prior gastric surgeries, are at eminent risk of bezoar formation. A multidisciplinary approach including cognitive behavioural therapy, dietary education and pharmacotherapy should be taken to prevent complications.

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