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KMID : 0371320090770030177
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Journal of the Korean Surgical Society
2009 Volume.77 No. 3 p.177 ~ p.183
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The Clinical Analysis of 12 Cases of Bezoars
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Park Jong-Seob
Jeong Jin-Ho
Lee Jong-Hoon
Moon Hyoun-Jong
Lee Jong-In
Park Jea-Kun
Shin Hyuk-Jai
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Abstract
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Purpose: Bezoars are the uncommon result of ingestion of poorly digestible or indigestible substances. It is defined as retained concretions of animal or vegetable material in the gastrointestinal tract. The aim of this study was to review and analyze in these cases with reviewing literature.
Methods: The medical records of 12 cases, treated between May 1999 and April 2009, were reviewed. The clinical characteristics, as well as the diagnostic evaluations and results of medical and surgical treatment, were also analyzed retrospectively.
Results: Of the 12 cases, 6 men and 6 women, the bezoars were in the stomach, jejunum and ileum or in both stomach and jejunum in 1, 2, 7 and 2 cases, respectively. 4 patients (33.3%) had a history of gastric or duodenal ulcer following previously received gastric surgery such as subtotal gastrectomy or truncal vagotomy with pyloroplasty. In 3 cases, the bezoars were found in operative field under the impression of intestinal obstruction due to adhesive ileus, which could not be found by preoperative radiologic evaluation. Among the 12 cases, 11 cases were successfully treated by operative and endoscopic removal, but 1 case expired due to sepsis.
Conclusion: A bezoar occurs mainly in patients who have previously undergone a gastric operation. Surgeons should keep in mind the possibility of bezoars in patients presenting an intestinal obstruction following a past gastric operation. The principle of treatment for bezoars used to be surgery, but recently gastric bezoars are often treated by gastrofiberscopy. (J Korean Surg Soc 2009;77:177-183)
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KEYWORD
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Bezoar, Intestinal obstruction, Acute abdomen
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