High Incidence of Gastric Bezoars in Cystic Fibrosis Patients after Lung Transplantation

Abstract

Gastric bezoars are common in cystic fibrosis patients after lung transplantation. The etiology is likely multifactorial, related to gastric motility, respiratory secretions, and medications. Further investigation is needed to understand the pathogenesis of bezoar formation in this selected population, and strategies for primary prevention may be beneficial.

Colon cancer in lung transplant recipients with CF: Increased risk and results of screening

“…Patients of age 13,18,30,31,31, and 41 at the time of diagnosis of colon cancer have been reported in the medical literature [7][8][9][10][11]. The risk for developing colon cancer at a young age may be increased for lung transplant recipients with CF due to impaired tumor surveillance as a consequence of the intense immunosuppression required to prevent lung allograft rejection.…”

“…These include complications of intestinal dysmotility (gastric bezoars, distal intestinal obstruction syndrome), biliary tract dysfunction (gastroesophageal reflux, mucosal ulcerations, hepatic cirrhosis, cholelithiasis, cholecystitis, biliary obstruction, acute pancreatitis, pseudomonas colitis, fatty liver), and gastrointestinal malignancy [15][16][17][18][19][20]. These potential complications can complicate the post-transplant course of patients and cause significant morbidity or death, and the immunosuppressive drug regimen that recipients must receive to prevent allograft rejection can cause adverse GI reactions (nausea, diarrhea) or increase the risk of infectious complications (enteric cytomegalovirus infection, pseudomembranous colitis, other GI tract infection).…”

Management of gastroparesis‐associated malnutrition

“…The incidence of bezoar formation determined by barium study of GP patients has been estimated to be around 6% . The formation of bezoars in the stomach is associated with GP secondary to vagotomy, hypothyroidism, cystic fibrosis and DM . The pathophysiology of bezoar formation includes a lack of antral–pyloric grinding mechanisms and the absence of MMC.…”

“…31 The formation of bezoars in the stomach is associated with GP secondary to vagotomy, hypothyroidism, cystic fibrosis and DM. [32][33][34][35] The pathophysiology of bezoar formation includes a lack of antral-pyloric grinding mechanisms and the absence of MMC. It is important to consider bezoar formation in patients with GP due to the associated risk of malnutrition and symptom exacerbation.…”

Multimodality imaging of adult gastric emergencies: A pictorial review

“…[36] The risk factors for phytobezoar include gastric dysmotility including postoperative gastroparesis, pancreatic exocrine dysfunction, cystic fibrosis, and cyclosporine use. [3738] Bezoars can also extend into the small bowel causing obstruction. Mottled density within a distended stomach can be seen on plain radiograph and barium fluoroscopy [Figure 14].…”