Spontaneous choledochoduodenal fistula is a rare complication of peptic ulcer disease, and surgical is generally directed towards the ulcer itself. We present 2 cases with spontaneous choledochoduodenal fistula due to peptic ulcer disease. One of our cases is a 27-year-old male who had a 3-year history of duodenal ulcer, while the other patient is a 56-year-old female who had a 5-year history of peptic ulcer and developed pyloric stenosis in the last month before hospitalization. Both these patients were successfully treated by truncal vagotomy with antecolic gastrojejunostomy. They were asymptomatic for follow-up periods of 8 months and 6 years, respectively.
The word ‘bezoar’ is derived from the Arabic ‘badzehr’ which means antidote or counterpoison. Trichobezoars (hair) and phytobezoars (vegetable matter) may be found in the gastrointestinal tract of humans. In this case report we present two cases with bezoar and their treatment. A 36-year-old mentally retarded woman was admitted to the hospital and referred to the surgery clinic since an epigastric mass was palpated. The major complaint of the patient was loss of hair and an epigastric discomfort was sometimes present. The bezoar was visualized with a gastroscopic examination. It was extracted through a gastrostomy incision after laparotomy. The alopecia of the patient was found to be related to trichophagy. The other case was a 42-year-old man with complaints of epigastric pain and dyspepsia. He had received H2 receptor blocker treatment for 1 month. He gave a history of persimmon ingestion 3 weeks prior to the hospital admission and since then his complaints were augmented. With a gastroscopic examination a phytobezoar coexisting with gastric ulcer disease was found. We performed subtotal gastrectomy and Billroth II procedure since gastric malignancy could not be ruled out with the frozen section investigation.
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