Gastric Bezoar After Lung Transplantation in Non–Cystic Fibrosis Patients and Review of the Literature

Folch, Erik; Shakoor, Hasan; Gómez, Javier; Hogan, Kathleen A.; Mason, David P.; Murthy, Sudish C.; Pettersson, Gösta; Mehta, Atul C.; Budev, Marie

doi:10.1016/j.healun.2007.05.005

Cited by 6 publications

(2 citation statements)

References 20 publications

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“…Gastroparesis is a neuropathic disorder wherein the movement of food through the gastrointestinal tract is impaired. Complications include early satiety and vomiting, weight loss, gastroesophageal reflux disease (GERD) with recurrent aspiration and pneumonia (1), and even gastric bezoars (2). Studies have shown that gastroparesis is common in lung‐transplant recipients, with a prevalence of 23–91% (3–8).…”

mentioning

confidence: 99%

Prevalence of gastroparesis before and after lung transplantation and its association with lung allograft outcomes

Raviv

D’Ovidio

Pierre

et al. 2011

Clinical Transplantation

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The main cause of late morbidity and mortality after lung transplantation is bronchiolitis obliterans syndrome (BOS). This study assesses the prevalence of gastroparesis among lung-transplant recipients and its association with BOS. The files of 139 patients who underwent nuclear gastric emptying studies before and/or three and 12 months after lung transplantation were reviewed, and the correlation of gastric emptying time (GET) at each time point with the occurrence of acute rejection or BOS (stage 0p or higher) was evaluated. Delayed gastric emptying (DGE; t(1/2) > 90 min) was documented in 50% of patients before transplantation - 74% at three months and 63% at 12 months. Median pre-transplant t(1/2) was 108 min in patients who acquired BOS and 77 min in BOS-free patients (p = 0.022). Among patients with pre-transplant DGE, 58% were BOS-free at 24 months post-operatively and 37% at 36 months; corresponding rates in patients with normal motility were 78% and 63% (p = 0.084). On multiple regression analysis adjusting for other measures of upper gastrointestinal dysfunction, GET before or three months after transplantation was significantly associated with BOS (OR 1.05 [95% CI 1.01-1.09] and OR 1.001 [1.001-1.005] per minute t(1/2)). Gastroparesis is common in lung-transplant recipients and associated with the development of BOS.

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mentioning

confidence: 99%

Prevalence of gastroparesis before and after lung transplantation and its association with lung allograft outcomes

Raviv

D’Ovidio

Pierre

et al. 2011

Clinical Transplantation

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“…Early on, trichobezoars might cause symptoms that are not specific [13]. Bezoars have rarely been linked to gastrointestinal complications such as intestinal perforation, peritonitis, protein-losing enteropathy, steatorrhea, pancreatitis, intussusception, obstructive jaundice, appendicitis, constipation, and pneumatosis intestinalis [17,18]. Here, we present a case of Rapunzel syndrome with jejunal perforation, found in a 15-year-old female patient with no significant past medical history.…”

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confidence: 94%

Rapunzel Syndrome in a Teenage Girl: A Case Report

Sivasubramanian¹,

Ashokkumar²,

Afzal³

et al. 2022

Cureus

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Trichobezoars are concretions of retained, undigested material, mostly hair or hair-like fibers in the stomach. Rapunzel syndrome is the condition when trichobezoars extend into the small bowel, leading to various complications including bowel obstruction, and perforation due to pressure necrosis.We present an interesting case of trichobezoar in a 15-year-old female patient, who presented with abdominal pain for one month duration. The exam was notable for a firm palpable mass in the epigastric area associated with localized tenderness and guarding. Contrast-enhanced CT of the abdomen showed a distended stomach with the bezoar, dilated duodenal loops, and clumping of proximal jejunal loops. Upper gastrointestinal endoscopy showed a trichobezoar extending from the oesophagogastric junction to the pylorus. Endoscopic removal of the trichobezoar was not successful.An elective laparotomy was performed, during which the stomach, duodenum, and proximal jejunum were dilated. The trichobezoar, measuring 35 cm in length, extended from the body of the stomach to the proximal jejunum and caused jejunal perforation due to pressure necrosis. The trichobezoar was removed and primary closure of jejunal perforation with diversion gastrojejunostomy and jejunostomy was done. There were no postoperative complications. The patient followed up with psychiatry in the clinic after discharge, she was diagnosed with trichotillomania and started on fluoxetine, with improvement in her behavioral symptoms.In young female patients with nonspecific chronic abdomen pain and a palpable mass, trichobezoar should be considered in the differential diagnosis. Contrast-enhanced abdomen CT is the preferred imaging modality and removal of the trichobezoar with an appropriate endoscopic or surgical procedure is the treatment of choice. It is essential to diagnose and treat the underlying behavioral condition to prevent recurrent episodes.

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Lung Transplantation

Budev¹

2012

Perioperative Management of Patients With Rheumatic Disease

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Gastric Bezoar After Lung Transplantation in Non–Cystic Fibrosis Patients and Review of the Literature

Cited by 6 publications

References 20 publications

Prevalence of gastroparesis before and after lung transplantation and its association with lung allograft outcomes

Prevalence of gastroparesis before and after lung transplantation and its association with lung allograft outcomes

Rapunzel Syndrome in a Teenage Girl: A Case Report

Lung Transplantation

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