Bezoar-induced small bowel obstruction: Clinical characteristics and diagnostic value of multi-slice spiral computed tomography

Wang, Peiyuan; Wang, Xia; Zhang, Lin; Li, Haifei; Liang, Changhong; Wang, Xu; Wang, Bin

doi:10.3748/wjg.v21.i33.9774

Cited by 42 publications

(69 citation statements)

References 32 publications

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“…They concluded that CT scan was successful in identifying 100% of their patients with BI-SBO. Bezoars showed on the CT as ‘lumps with clear edges inside the intestinal cavity’ 6. They further discussed the use of contrast enhanced CT. Of their 35 patients, 18 underwent non-contrast abdomen and pelvis CT, and 17 had a contrast-enhanced examination.…”

Section: Discussionmentioning

confidence: 99%

“…Wang et al 6 investigated the use of CT in diagnosing BI-SBO. They concluded that CT scan was successful in identifying 100% of their patients with BI-SBO.…”

Section: Discussionmentioning

confidence: 99%

“…Thus, Wang et al 6 advise that bezoars are identified on CT as encapsulated lumps at the zone of obstruction with a clear edge and a ‘bubble like, mottled behaviour’. Whereas, faeces have a longer longitudinal diameter, no capsule, and tend to be at the proximal end of the obstruction site.…”

Section: Discussionmentioning

confidence: 99%

“…Oh et al 4 support this, having treated one case with milking and fragmentation and one case with laparoscopic jejunostomy for removal of the bezoar. Wang et al 6 treated four patients with endoscopic suction fragmenting the bezoars, and 24 underwent laparotomy. Glatstein et al discussed a case of rhubarb-bezoar-induced small bowel obstruction in a 4-year-old boy.…”

Section: Discussionmentioning

confidence: 99%

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Two cases of small bowel obstruction secondary to a swallowed potato

et al. 2015

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Bowel obstruction due to bezoars (compaction of ingested material within the gastrointestinal tract) is a rare, but well documented occurrence. In this paper, we present two cases of potato-induced small bowel obstruction. Both patients were approximately 50 years old and had cerebral palsy and learning disabilities, respectively. They presented with abdominal pain and bilious vomiting, with no medical or surgical history. Diagnosis of small bowel obstruction was confirmed by CT prior to taking the patients to the operating theatre, where whole potatoes were found to be obstructing each patient's bowel lumen. Both patients underwent laparotomy with enterotomy and removal of the potato. They both made a good recovery. Through a literature review of bezoar-induced bowel obstruction, these cases highlight important diagnostic and management principles.

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Section: Discussionmentioning

confidence: 99%

“…Wang et al 6 investigated the use of CT in diagnosing BI-SBO. They concluded that CT scan was successful in identifying 100% of their patients with BI-SBO.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Two cases of small bowel obstruction secondary to a swallowed potato

et al. 2015

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“…In all these cases symptoms are similar and include abdominal pain, nausea and vomiting, inability to pass gas or bowel movements, and sometimes fever [1], so a correct differential diagnosis is important. Bezoars represent an infrequent cause of mechanical SBO and can occur in 0.4–4% of total cases, according to different authors [2–4].…”

Section: Introductionmentioning

confidence: 99%

A rare case of a double phytobezoar causing gastric and jejunum obstruction in an adult man: a case report

et al. 2016

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BackgroundBezoars are an uncommon cause of mechanical intestinal occlusion. There are four different kinds of bezoars: phytobezoars, made of vegetables and fibers; trichobezoars, resulting from the ingestion of hair and frequently an expression of psychiatric disorders; lactobezoars, which are formed of milk curd; and pharmacobezoars, caused by drugs and medications. Symptoms are classically indistinguishable from one another and from more common causes of intestinal occlusion, so it can be difficult to establish a correct diagnosis in order to apply the correct treatment. We present a rare case of two different phytobezoars causing intestinal occlusion (gastric and jejunal). We also describe the correct techniques for making a correct and fast diagnosis of occlusion caused by phytobezoars, and the possible conservative and operative treatments.Case presentationWe present the case of a double phytobezoar that was surgically treated with a double enterotomy. Our patient was a 68-year-old Caucasian man with a medical history of hypertension, a previous open appendectomy, and open repair of a perforated gastric ulcer. He was admitted with a 5-day history of abdominal pain located in his upper quadrants along with vomiting. After a preoperative examination, he was taken to the operating room. He was discharged in a good clinical condition 11 days after surgical intervention. A physical examination at 6 months demonstrated our patient was in good health.ConclusionsDiagnosing bezoars is difficult because of their rarity. However, they must be taken into consideration in a differential diagnosis because their treatment is not always surgical. In fact, it may be conservative in many cases and a correct diagnosis will guide towards the correct therapy.

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Intestinal bezoar aggravated by hypomotility of ischemic small intestine: A case report

Chiang

Yeh

Chang

et al. 2020

Adv in Digestive Medicine

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There is limited literature on the subject of intestinal bezoars in the setting of small bowel ischemia. Furthermore, no evidence‐based pathogenesis has been offered in current case reports. This report describes a unique case of small bowel ischemia with simultaneous bezoar aggravation in the small intestine. An 82‐year‐old woman with a history of diabetes mellitus and hyperlipidemia presented with intermittent severe postprandial abdominal pain over the last 2 days. An upper endoscopy 3 weeks prior revealed a gastric bezoar approximately 1.5 cm in diameter. However, during this visit, the gastric bezoar was not visible upon repeat upper endoscopy. A plain abdominal X‐ray was ordered and revealed patterns consistent with small bowel ileus. Upon further investigation, an abdominal computed tomography revealed mid‐ileum vessel delayed arterial enhancement and dilatation of the proximal ileum. This finding is consistent with intestinal ischemia‐induced congestion and bowel obstruction. Bowel perforation was also suspected. A subsequent laparoscopic surgery revealed a bezoar at the level of bowel ischemia. The bezoar was removed and the ischemic segment was resected. Coexistence of intestinal bezoar and small bowel ischemia is rare. Based on the patient's clinical evidence and published experimental evidence, we hypothesized that intestinal ischemia predisposes a patient to intestinal hypomotility, causing bezoar aggravation or formation in the small intestine. Early treatment of gastric bezoars and consideration of bowel ischemia risk due to atherosclerosis are crucial to minimizing bezoar complications.

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Bezoar-induced small bowel obstruction: Clinical characteristics and diagnostic value of multi-slice spiral computed tomography

Abstract: BI-SBO exhibits regional and seasonal characteristics. CT planar and contrast-enhanced scanning can be applied to diagnose and observe vascular conditions in obstructed zones.

Cited by 42 publications

References 32 publications

Two cases of small bowel obstruction secondary to a swallowed potato

Two cases of small bowel obstruction secondary to a swallowed potato

A rare case of a double phytobezoar causing gastric and jejunum obstruction in an adult man: a case report

Intestinal bezoar aggravated by hypomotility of ischemic small intestine: A case report

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