Clinical Characteristics and Treatment Outcomes Among Patients With Gastrointestinal Phytobezoars: A Single-Institution Retrospective Cohort Study in Korea

Yang, Song-Soo; Cho, Min Jeng

doi:10.3389/fsurg.2021.691860

Cited by 9 publications

(10 citation statements)

References 23 publications

(48 reference statements)

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“…Patients with a bezoar in the small bowel present with ileus, intestinal ischemia, or perforation, in which surgical procedures are inevitable. 11,18 In this study, 88% of patients with a small bowel bezoar presented with ileus, and surgical management was necessary for 61% of patients. A minimally invasive surgical procedure is a preferred method.…”

Section: Clinical Course Of Patients With a Bezoar In The Duomentioning

confidence: 76%

A Single-center 12-year Experience of Patients with Gastrointestinal Bezoars

Kang¹,

Park²,

You³

et al. 2023

Korean J Gastroenterol

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Background/Aims: Gastrointestinal (GI) bezoars are relatively rare diseases with clinical characteristics and treatment modalities that depend on the location of the bezoars. This study evaluated the clinical characteristics and treatment outcomes in patients with GI bezoars. Methods: Seventy-five patients diagnosed with GI bezoars were enrolled in this study. Data were collected on the demographic and clinical characteristics and the characteristics of the bezoars, such as type, size, location, treatment modality, and clinical outcomes. Results: Among the 75 patients (mean age 71.2 years, 38 males), 32 (42.6%) had a history of intra-abdominal surgery. Hypertension (43%) and diabetes (30%) were common morbidities. The common location of the bezoars was the stomach in 33 (44%) and the small intestine in 33 (44%). Non-surgical management, including adequate hydration, chemical dissolution, and endoscopic removal, was successful in 2/2 patients with esophageal bezoars, 26/33 patients with gastric bezoars, 7/9 patients with duodenal bezoars, and 20/33 patients with small intestinal bezoars. The remaining patients had undergone surgical management. Conclusions: The management of GI bezoars requires multidisciplinary approaches, including the appropriate correction of fluid and electrolyte imbalances, chemical dissolution, and endoscopic and surgical treatments.

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Section: Clinical Course Of Patients With a Bezoar In The Duomentioning

confidence: 76%

A Single-center 12-year Experience of Patients with Gastrointestinal Bezoars

Kang¹,

Park²,

You³

et al. 2023

Korean J Gastroenterol

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“…Fiber-rich foods, such as fruits (persimmon, figs, raisins, etc) and vegetables (celery, pumpkin, vegetable skins, etc), are the most often cited culprits. Their constituent components, cellulose, lignin, hemicellulose, and/or tannins, polymerize and aggregate within the stomach forming a phytobezoar 14 . Predisposing factors to phytobezoar formation include conditions that alter gastrointestinal motility (hypothyroidism and diabetes mellitus, etc) or stomach anatomy and physiology (previous gastric surgery), as well as dental problems that may impair chewing and swallowing, among other factors 14 .…”

Section: Discussionmentioning

confidence: 99%

“…Their constituent components, cellulose, lignin, hemicellulose, and/or tannins, polymerize and aggregate within the stomach forming a phytobezoar 14 . Predisposing factors to phytobezoar formation include conditions that alter gastrointestinal motility (hypothyroidism and diabetes mellitus, etc) or stomach anatomy and physiology (previous gastric surgery), as well as dental problems that may impair chewing and swallowing, among other factors 14 . A review of the literature suggests at least one fatal case of colonic obstruction secondary to a phytobezoar (multiple artichoke fragments) in an elderly, edentulous woman 15 .…”

Section: Discussionmentioning

confidence: 99%

“…14 Predisposing factors to phytobezoar formation include conditions that alter gastrointestinal motility (hypothyroidism and diabetes mellitus, etc) or stomach anatomy and physiology (previous gastric surgery), as well as dental problems that may impair chewing and swallowing, among other factors. 14 A review of the literature suggests at least one fatal case of colonic obstruction secondary to a phytobezoar (multiple artichoke fragments) in an elderly, edentulous woman. 15 In this case, death was attributed to acute peritonitis secondary to the intestinal occlusion.…”

Section: Discussionmentioning

confidence: 99%

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Fatal Rapunzel Syndrome

Żyła

Jacques

2023

Am J Forensic Med Pathol

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We report a rare case of a young child, younger than10 years, who died of complications related to trichophagia and multiple gastrointestinal trichobezoars. One year before death, the child's clinical history yielded a diagnosis of iron deficiency anemia, believed to be related to poor diet, and alopecia areata, the etiology of which was unknown. Two weeks before death, the child presented with complaints of intermittent “flu-like” symptoms and vomiting. The child reported abdominal pain, anorexia, and fatigue on the night before death. The next morning, the child ate breakfast and was subsequently discovered unresponsive. On external examination, there were areas of thinning head hair. Postmortem computed tomography, magnetic resonance imaging, and internal examination revealed 3 distinct trichobezoars, occupying the stomach, jejunum, and ileum. This was complicated by small bowel obstructions and perforations due to the trichobezoars. The cause of death was peritonitis secondary to small bowel perforations due to small bowel obstruction with multiple trichobezoars. This is the first case report to demonstrate the utility of postmortem computed tomography and magnetic resonance imaging in characterizing the nature and extent of trichobezoars in a fatal case of Rapunzel syndrome.

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“…Dyspepsia is not correlated with TSH levels, radioscintigraphy or with other EGG parameters. Hypothyroidism patients may show up with phytobezoars in their stomach particularly following gastric surgery ( Yang and Cho, 2021 ). Intestinal bezoars may cause obstruction ( Bouali et al, 2021 ).…”

Section: Hypothyroidism and Gi Motilitymentioning

confidence: 99%

Thyroid disorders and gastrointestinal dysmotility: an old association

Xu,

Hu,

et al. 2024

Front. Physiol.

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Gastrointestinal motility symptoms may be closely related to thyroid diseases. Sometimes, such symptoms are the only thyroid disease-related clue although the degree of the symptoms may vary. The exact mechanism of action of thyroid hormones on gastrointestinal motility is not completely understood, however, a clue lies in the fact that muscle cell receptors can be directly acted upon by thyroxines. Both hypo- and hyperthyroidism can cause impairment of gastrointestinal motility, modifying structure and function of pharynx and esophagus, and regulating esophageal peristalsis through neuro-humoral interaction. In hyperthyroid patients, alterations of postprandial and basic electric rhythms have been observed at gastro-duodenal level, often resulting in slower gastric emptying. Gastric emptying may also be delayed in hypothyroidism, but an unrelated gastric mucosa-affecting chronic modification may also cause such pattern. Hyperthyroidism commonly show malabsorption and diarrhoea, while hypothyroidism frequently show constipation. In summary, it can be stated that symptoms of gastrointestinal motility dysfunction can be related to thyroid diseases, affecting any of the gastrointestinal segment. Clinically, the typical thyroid disease manifestations may be missing, borderline, or concealed because of intercurrent sicknesses. Motility-linked gastrointestinal problems may easily conceal a misdetected, underlying dysthyroidism that should be carefully analyzed. Here, we aim to elaborate on the associations between thyroid disorders and GI dysmotility and the common clinical manifestations associated with GI dysmotility.

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Clinical Characteristics and Treatment Outcomes Among Patients With Gastrointestinal Phytobezoars: A Single-Institution Retrospective Cohort Study in Korea

Cited by 9 publications

References 23 publications

A Single-center 12-year Experience of Patients with Gastrointestinal Bezoars

A Single-center 12-year Experience of Patients with Gastrointestinal Bezoars

Fatal Rapunzel Syndrome

Thyroid disorders and gastrointestinal dysmotility: an old association

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