Ultrastructural analysis of a gastric persimmon phytobezoar

Iwamuro, Masaya; Urata, Haruo; Furutani, Masumi; Kawai, Yosuke; Shiraha, Hidenori; Takaki, Akinobu; Okada, Hiroyuki; Yamamoto, Kazuhide

doi:10.1016/j.clinre.2013.11.005

Cited by 11 publications

(13 citation statements)

References 8 publications

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“…Our study results are consistent with those previously reported that indicated that Coca-Cola is ineffective for dissolving persimmon phytobezoars (6,8,(15)(16)(17). In our previous study, we investigated the ultrastructure of a persimmon bezoar by scanning electron microscopy and found that a high-density layer 20-to 50-μm thick constituted the exterior of the phytobezoar (18). Moreover, microgranules formed the exterior surface of the persimmon phytobezoar, which aggregated and created an almost seamless structure with only a few slits.…”

Section: Discussionsupporting

confidence: 93%

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An Energy Dispersive X-ray Spectroscopy Analysis of Elemental Changes of a Persimmon Phytobezoar Dissolved in Coca-Cola

Iwamuro

Urata

Higashi³

et al. 2016

Intern. Med.

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To investigate the mechanism of phytobezoar dissolution by Coca-Cola , persimmon phytobezoar pieces removed from a 60-year-old Japanese woman were analyzed by energy dispersive X-ray spectroscopy. The amount of calcium significantly decreased after dissolution treatment using Coca-Cola , suggesting a potential contribution of calcium to dissolution mechanisms. Moreover, immersion in Coca-Cola for 120 hours on the exterior surface revealed that Coca-Cola did not permeate persimmon phytobezoars. This is the first study to investigate the mechanisms of persimmon phytobezoar permeability and dissolution induced by Coca-Cola .

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Section: Discussionsupporting

confidence: 93%

“…2A and B). Although unoccupied areas existed in the inner part, continuous arrangement of the sheet-like structures likely blocks permeation of liquids (18).…”

Section: Discussionmentioning

confidence: 99%

An Energy Dispersive X-ray Spectroscopy Analysis of Elemental Changes of a Persimmon Phytobezoar Dissolved in Coca-Cola

Iwamuro

Urata

Higashi³

et al. 2016

Intern. Med.

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“…A final total of 19 patients were retrospectively registered in this study. Some of these 19 patients were also subjects of our previous studies (23)(24)(25).…”

Section: Methodsmentioning

confidence: 99%

Clinical Characteristics and Treatment Outcomes of Nineteen Japanese Patients with Gastrointestinal Bezoars

et al. 2014

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Objective To analyze the clinical characteristics of patients with gastrointestinal bezoars and their response to therapy. Patients We retrospectively reviewed the cases of 19 patients diagnosed with gastrointestinal bezoars at the Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences or one of 15 collaborating institutions between December 2004 and August 2013. We investigated the epidemiology and etiology of the gastrointestinal bezoars by determining the gender, age at diagnosis, medical history, symptoms, complications, modalities used for diagnosis, treatments, outcomes and bezoar location, color and contents. Results There were 17 patients with gastric bezoars and two patients with small intestinal bezoars. All patients were 62 years of age or older, except for one case of a trichobezoar in a 10-year-old patient. Some of the patients had a history of surgery of any part of the gastrointestinal tract (n=5) and/or diabetes mellitus (n=2). The two patients with small intestinal bezoars required surgical removal in order to relieve ileus. Approximately one-half of the patients with gastric bezoars had ulcerations in the stomach (9/17 patients, 52.9%) and/or gastrointestinal bleeding (8/17, 47.1%). Endoscopic fragmentation was performed in 10 patients, whereas bezoar dissolution was achieved with a gastroprokinetic agent (n=1) and without any treatment (n=3) in the remaining cases. Conclusion As previously reported, elderly individuals with a positive history of surgery and/or diabetes mellitus were observed in this bezoar patient series. Gastric ulcers and gastrointestinal bleeding were frequently observed. The majority of patients underwent endoscopic fragmentation, while spontaneous resolution of the gastric bezoar was observed in several cases.

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“…Phytobezoars, resulted from ingestion of vegetable and plant material of certain types, are indigestible masses trapped in the gastrointestinal tract [1]. The most common cause of this type of bezoar is persimmon, which is very popular in many Asians countries [2]. Patients with persimmon phytobezoar may experience epigastric discomfort, abdominal pain, vomiting, and in severe cases, gastric ulceration, upper gastrointestinal bleeding, and perforation [3].…”

Section: Introductionmentioning

confidence: 99%

An Unusual Cause of Duodenal Obstruction: Persimmon Phytobezoar

Fan

Wang

2016

Indian J Surg

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Duodenal phytobezoar, an unusual cause of acute duodenal obstruction, is rarely seen. The most common cause of this type of bezoar is persimmon. It frequently arises from underlying gastrointestinal tract pathologies (gastric surgery, etc.). Here, we report the case of a 66-year-old man who had undergone distal gastrectomy with Billroth I reconstruction for gastric cancer and experienced severe epigastric discomfort, abdominal pain, and vomiting for a few days. The abdominal computed tomography scan showed a large-sized mass in the horizontal portion of the duodenum. On following endoscopic examination, a large phytobezoar was revealed in the duodenum. He was treated with endoscopic fragmentation combined with nasogastric Coca-Cola. The patient tolerated the procedure well and resumed a normal oral diet 3 days later.

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Ultrastructural analysis of a gastric persimmon phytobezoar

Cited by 11 publications

References 8 publications

An Energy Dispersive X-ray Spectroscopy Analysis of Elemental Changes of a Persimmon Phytobezoar Dissolved in Coca-Cola

An Energy Dispersive X-ray Spectroscopy Analysis of Elemental Changes of a Persimmon Phytobezoar Dissolved in Coca-Cola

Clinical Characteristics and Treatment Outcomes of Nineteen Japanese Patients with Gastrointestinal Bezoars

An Unusual Cause of Duodenal Obstruction: Persimmon Phytobezoar

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