Relapsing massive metal bezoar: a case report

Abstract

IntroductionBezoars are uncommon findings in the gastrointestinal tract and are composed of a wide variety of materials. We report a case of a relapsing metal bezoar in a man with schizophrenia.Case presentationA 34-year-old man presented with a history of sub-acute onset of mild diffuse abdominal pain and abdominal distention. Physical examination revealed dullness to percussion in the upper and lower left quadrants. Past medical history was remarkable for epilepsy, schizophrenia and previous abdominal surgery for intestinal occlusion. Plain radiographs revealed objects of metal density contained within a dilated stomach. Celiotomy was performed revealing more than 350 metal objects inside the stomach. The patient was discharged and referred to a psychiatric facility.ConclusionIntestinal occlusion in patients with psychiatric disorders can result from rare causes such as bezoars. This report alerts surgeons to rule out bezoars in the differential diagnosis of intestinal occlusion in people with mental health problems.

Discussing treatment strategies for acute mechanical intestinal obstruction caused by phytobezoar: A single-center retrospective study

“…chronic intestinal pseudoobstruction, neurogenic motility disorders), they are more frequent in patients having eating disorders or in patients who are diabetic. [3] Different treatment methods have been described regarding its management. Although the approach may differ according to the clinical status of the patient, mostly used regimens, such as N-acetylcysteine (NAC), papain, metoclopramide, cellulase enzyme preparations, 'diet Coca-Cola™', are preferred in the first stage, and surgical interventions are chosen for cases where endoscopic intervention and conservative treatment fails.…”

Recurrent gastric metal bezoar: a rare cause of gastric outlet obstruction

“…However, other bezoars could occur in ‘abnormal’ stomach, for instance, in cases of decreased gastric motility (eg, diabetes mellitus, previous vagotomy, drugs), previous gastrectomy (Billroth 2, gastric bypass), hypochlorydria, gastric stasis, loss of pyloric function and hypothyroidism. 7 Clinical manifestations vary widely depending on the location of the bezoar that could be anywhere in, the digestive tract and can go from asymptomatic, non-specific symptoms to more serious intestinal obstruction, GI bleeding, perforation and peritonitis. 9 Metal bezoar can be seen on plain radiographs unless they are radiolucent but CT scan is usually necessary and help identifying localisation and possible complications due to these foreign bodies.…”

Colonic bezoar caused by cracked-wheat consumption

“…4 An important consideration is that approximately 10% of patients who present with bezoars show psychiatric abnormalities or mental retardation, indicating that psychiatric evaluation and treatment are necessary to prevent recurrence in a significant proportion. 5 Such was the case of the patient described here, who presented with a history of psychiatric diagnosis and antipsychotic medication intake. Accordingly, he was transferred to the psychiatric clinic after the ileus had regressed.…”