Imaging differentiation of phytobezoar and small-bowel faeces: CT characteristics with quantitative analysis in patients with small- bowel obstruction

Chen, Ya-Cheng; Liu, Chang-Hsien; Hsu, Hsian-He; Yu, Chih-Yung; Wang, Hong-Hau; Fan, Huiying; Chen, Ran‐Chou; Chang, Wei‐Chou

doi:10.1007/s00330-014-3486-1

Cited by 28 publications

(19 citation statements)

References 20 publications

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“…[11] Chen et al . [12] showed that a higher grade of obstruction is commonly associated with phytobezoar impaction without mesenteric fatty stranding and intraperitoneal fluid; moreover, they found that a combination of the food debris length <9.5 cm and the mean attenuation value <11.75 HU of the obstructed bowel at the transition point was suggestive for phytobezoar, such as in our patient. Although these features are typically found in the small bowel, they may also be considered very useful in the large bowel.…”

Section: Discussionsupporting

confidence: 63%

An unusual sigmoid phytobezoar in a patient with a transplanted kidney: A case report

Milillo

Moffa

Bertozzi

et al. 2016

Indian Journal of Radiology and Imaging

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Bezoars are masses formed by the concretion of stomach contents or debris within the gastrointestinal tract. Bezoars are rare and account for only 0.4–4% of all cases of gastrointestinal obstruction and mainly occur in the stomach or small intestine. Intestinal obstruction caused by colonic bezoars is extremely rare. A 39-year-old man with a transplanted kidney came to the hospital because of abdominal pain, constipation, and distension. We performed an abdominal computed tomography scan and found an ovoid intraluminal mass with a mottled gas pattern in the distal sigmoid colon. Subsequently, the patient underwent laparotomic surgery and removal of the bezoar. We report a rare case of large bowel obstruction due to colonic phytobezoar, which was confirmed intraoperatively.

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Section: Discussionsupporting

confidence: 63%

An unusual sigmoid phytobezoar in a patient with a transplanted kidney: A case report

Milillo

Moffa

Bertozzi

et al. 2016

Indian Journal of Radiology and Imaging

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“…However, there is no consensus on the diagnostic value of these CT findings [6,[8][9][10][11][12]26,27]. In addition, findings of feces sign and intraperitoneal free fluid had many different etiologies such as malignity, metabolic causes and cirrhosis [11,26,28]. Thus lead to decrease in sensitivity and specificity of this CT signs in our study.…”

Section: Discussionmentioning

confidence: 78%

İnce bağırsak obstrüksiyonlu hastaların tanısında bilgisayarlı tomografi bulgularının rolü

et al. 2018

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Bu prospektif araştırmanın amacı, ince barsak tıkanıklığı (İBT) değerlendirilmesinde bilgisayarlı tomografi (BT) bulgularının prognostik değerini araştırmaktır. Hastalar ve Yöntem: Akut karın ağrısı olan ve İBT araştırılmasında BT çekilen altmış hasta çalışmamıza dahil edildi. Bunlardan, 47 hasta (26 erkek; 21 kadın ve ortalama yaş; 60) nın sonuçları değerlendirildi. BT değerlendirme parametreleri olarak: mezenterik kirlenme, geçiş zonu, feces işareti, intramural hava ve intraperitoneal serbest sıvı kullanıldı. Bulgular: Mezenterik kirlenme, geçiş zonu ve intramural hava BT bulguları ile İBT tanısı arasında istatistiksel anlamlı ilişki bulundu (p<0.05). Bu BT bulguları İBT tanısında yüksek sensitivite ve pozitif prediktif değere (PPD) sahiptir. Mezenterik kirlenme, geçiş zonu ve intramural hava bulgularının kombinasyonu ile İBT tanısı arasında istatistiksel anlamlı bir ilişki saptandı (p<0.05). İnce barsak feces bulgusu ile intraperitoneal serbest sıvı bulgusunun İBT tanısı ile arasında istatistiksel anlamlı bir ilişki saptanmadı (p>0.05). Üç veya daha fazla BT bulgusunun beraber bulunması durumunda İBT tanısında istatistiksel anlamlı değeri olduğu saptandı (p<0.05). Sonuç: Mezenterik kirlenme ve geçiş zonu bulguları İBT tanısında en yüksek sensitivite ve PPD sahiptir. Mezenterik kirlenme, geçiş zonu ve intramural hava bulgularının kombinasyonu ile üç veya daha fazla BT bulgusunun beraber bulunması durumunda İBT tanısında spesifite belirgin oranda artmaktadır.

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“…In this study, most patients ( n = 49) showed an obstruction located at the ileum, which is consistent with the findings of most reports [ 7 ]. The reason may be related to the narrowing of the ileal lumen or the reduction of water content in the ileum [ 8 , 9 ]. When the small intestine is obstructed, owing to the inability of the intestinal contents to be discharged properly, gas and fluid accumulation occurs, leading to increased pressure of the intestinal cavity, expansion and congestion of the intestinal wall, intestinal mucosal ischemia and necrosis, and changes in intestinal flora structure.…”

Section: Discussionmentioning

confidence: 99%

Clinical Analysis of the Curative Effect of a Transnasal Ileus Tube in the Treatment of Small Bowel Obstruction Caused by a Phytobezoar

Lin

Wang

Liang

et al. 2020

Gastroenterology Research and Practice

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Objective. To investigate the curative effect of a transnasal ileus tube in the treatment of small bowel obstruction caused by a phytobezoar. Methods. Seventy-one patients with small bowel obstruction caused by a phytobezoar who underwent treatment in three provincial tertiary grade A hospitals in Fujian Province from March 2011 to February 2020 were included in this study. Patients were divided into the following two groups according to the treatment received: (1) conservative group, comprising patients who received medical conservative treatment, and (2) combined group, including patients who received combined medical conservative treatment and transnasal ileus tube placement. The clinical symptoms, changes in abdominal imaging, tube depth of the first day, reduction of pressure volume on the first day after catheterization, length of hospital stay, and nonsurgical rate were compared between the combined and conservative groups. Results. There was no significant difference in age, sex, history of previous abdominal surgery and abdominal radiotherapy, symptoms at admission, duration of symptoms before admission, signs at admission, laboratory data, and obstruction position between the combined and conservative groups. There was a statistically significant difference in the nonsurgical rate (19/24 vs. 23/47, P = 0.014 ) between the combined and conservative groups. Logistic analysis showed that the duration of symptoms before admission, albumin level, and use of a transnasal ileus tube might be independent factors affecting the transition to surgery for patients with small bowel obstruction caused by a phytobezoar ( P < 0.05 ). Conclusion. Timely conservative medical treatment with transnasal ileus tube placement can effectively improve the nonsurgical rate of small bowel obstruction caused by a phytobezoar. The duration of symptoms before admission, albumin level, and use of a transnasal ileus tube were closely related to whether patients with small bowel obstruction caused by phytobezoar were transferred to surgery.

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Imaging differentiation of phytobezoar and small-bowel faeces: CT characteristics with quantitative analysis in patients with small- bowel obstruction

Cited by 28 publications

References 20 publications

An unusual sigmoid phytobezoar in a patient with a transplanted kidney: A case report

An unusual sigmoid phytobezoar in a patient with a transplanted kidney: A case report

İnce bağırsak obstrüksiyonlu hastaların tanısında bilgisayarlı tomografi bulgularının rolü

Clinical Analysis of the Curative Effect of a Transnasal Ileus Tube in the Treatment of Small Bowel Obstruction Caused by a Phytobezoar

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