Giant rectosigmoid lithobezoar in a child: four significant clues obtained from history, abdominal palpation, rectal examination and plain abdominal X-ray

Tokar, Baran; Özkan, Ragıp; Ozel, Abdulllah; Koku, Naim

doi:10.1016/s1571-4675(03)00116-0

Cited by 14 publications

(19 citation statements)

References 6 publications

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“…On physical examination, sometimes, it is possible to palpate the organ filled with the stones, with a characteristic "crunch sign", which usually applies to the colon [4,9,10]. In the present case, given the palpation of the gastric bezoars with resulting singular sound, we strongly believe the concept also fits the stomach.…”

Section: Discussionsupporting

confidence: 50%

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Giant gastric lithobezoar in an adult: A case report

Borges¹,

Filho²,

Muniz³

2016

IJCRI

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International Journal of Case Reports and Images (IJCRI) is an international, peer reviewed, monthly, open access, online journal, publishing high-quality, articles in all areas of basic medical sciences and clinical specialties.Aim of IJCRI is to encourage the publication of new information by providing a platform for reporting of unique, unusual and rare cases which enhance understanding of disease process, its diagnosis, management and clinico-pathologic correlations. Case Report: A case of 49-year-old male, schizophrenic patient, with a prior history of pica presenting with non-specific symptoms and a 10-kg weight loss. Upon physical examination, an enormous palpable left mass was noted and when mobilized, it produced a peculiar sound. Diagnostic workup comprised exclusively plain radiographs, with pathognomonic findings and subsequent indication of surgery. Exploratory laparotomy revealed a 3.5-kg gastric bezoar encompassing diverse objects, but predominantly stones. There was no evidence of their presence in other organs and no complications. The patient had uneventful recovery and is currently engaged in outpatient follow-up. Conclusion: Pica with resulting bezoar should be suspected in psychiatric adult patients with non-specific symptoms. Giant upper gastrointestinal lithobezoars are very rare and may produce a gastric "crunch sign" on physical examination, which is a clue for the correct diagnosis. Open surgery is effective and can be the treatment of choice. IJCRI publishes

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Section: Discussionsupporting

confidence: 50%

“…This unique appearance, "corn on the cob" sign, is considered pathognomonic. In this particular type of bezoar there is no need for barium studies or other image methods [4,9,10].…”

Section: Discussionmentioning

confidence: 99%

Giant gastric lithobezoar in an adult: A case report

Borges¹,

Filho²,

Muniz³

2016

IJCRI

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“…In physical examination, abdominal distention and tenderness is mostly seen along with “colonic crunch sign” which is the palpation of the masses [6]. Stones can be palpated and extracted in rectal examination.…”

Section: Discussionmentioning

confidence: 99%

Intestinal Obstruction due to Colonic Lithobezoar: A Case Report and a Review of the Literature

Şenol

Özdemir

Şahiner

et al. 2013

Case Reports in Pediatrics

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Bezoar is defined as the accumulation of undigested foreign bodies or nutrients in the gastrointestinal tract. These foreign bodies can be hair (trichobezoar), fibers or seeds of vegetables and fruits (phytobezoar), or remnants of milk (lactobezoar) and stones (lithobezoar). Lithobezoar, the accumulation of stones in the digestive tract, is commonly seen in stomach. In this paper, a 7-year-old girl with colonic lithobezoar who presented with constipation, abdominal pain, and the history of pica was successfully treated by the extraction of the stones under general anesthesia.

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“…Abdominal palpation can reveal these thorn-like masses. This finding is referred to as the “colonic crunch sign” 4. Abdominal x ray is particularly important in the diagnosis of colonic lithobezoars.…”

Section: Discussionmentioning

confidence: 99%

“…Abdominal x ray is particularly important in the diagnosis of colonic lithobezoars. The presence of numerous radiopaque masses in the lower abdomen or the rectosigmoid junction, referred to as “corn on the cob”,4 is pathognomonic for lithobezoars. Our patient also demonstrated this finding with colonic gas distention and some small air–fluid levels at the left upper quadrant (fig 1).…”

Section: Discussionmentioning

confidence: 99%