Learning objectives
The purpose of this exhibit is to demonstrate computed tomography (CT) findings of gastrointestinal phytobezoars and present the demographic characteristics,
localization,
numbers and operation types of the patients who were operated for bezoar in our clinic.
Background
A bezoar can be classified into different groups according to component sources:phytobezoar,
trichobezoar,
drug bezoar or lactic acid bacterium bezoar.
Phytobezoars are collections of incompletely digested food material within the alimentary tract which a rare cause of small bowel obstruction(SBO).
Computed tomography is superior to other radiologic techniques for bezoar diagnosis and differential diagnosis in patients with intestinal obstruction. The treatment of SBO caused by a bezoar is surgical,
either by fragmentation and milking of the bezoar into the cecum or by enterotomy with bezoar...
Findings and procedure details
The records of 122 patients who underwent preoperative abdominal CT and subsequent operation with a diagnosis of intestinal obstruction due to bezoars were retrospectively analyzed in Sakarya University Faculty of Medicine,
Department of General Surgery from January 2012 to September 2018.
The female-male ratio was 65:57 (1.14:1),
and the mean age was 57.9 (23–89) years.
A total of 158 bezoars were found in 122 patients,
of whom 23 (18.8%) had multiple bezoars.
Bezoars were most commonly located in the ileum (n=57-46,8%).
Other bezoar locations include...
Conclusion
CT is superior to other radiologic tools for diagnosis and differential diagnoses in patients with intestinal obstruction based on clinical and abdominal X-ray findings.
Preoperative CT examination can obtain very valuable information about the level of obstruction,
aetiology and presence of additional pathology,
and can facilitate the planning of the operation type.
Delay in the diagnosis can lead to pressure necrosis,
gangrene and even perforation.
Personal information
G.
Çakmak1,
K.
Özdemir2,
M.
Y.
Uzunoğlu3,
F.
Altintoprak4; 1Sakarya/TR,
2Sakarya,
Turkey/TR,
3Siirt/TR,
4İstanbul/TR
1Sakarya Teaching and Research Hospital,
Department of General Surgery,
Sakarya,
Turkey
2 Sakarya University,
Faculty of Medicine,
Department of General Surgery,
Sakarya,
Turkey
3 Siirt State Hospital,
Department of General Surgery,
Siirt,
Turkey
4 Istinye University,
Faculty of Medicine,
Department of General Surgery,
Istanbul,
Turkey
References
1.
Kuang LQ,
Zhao DW,
Cheng C,
Wang Y.
Prediction of Small Bowel Obstruction Caused by Bezoars Using Risk Factor Categories on Multidetector Computed Tomographic Findings.
BioMed Research International.
2016;2016:6569103
2.Sameer A.
Hirji,
Faith C.
Robertson,
Grace F.
Chao,
Bharti Khurana,
and Jonathan D.
Gates.
Phytobezoar: A Brief Report with Surgical and Radiological Correlation.
Case Reports in Surgery.
Case Rep Surg.
2018; 2018: 5253162
3.Akrami M,
Sasani MR.Dietary Habits Affect Quality of Life: Bowel Obstruction Caused by Phytobezoar.
Iran J Public Health.
2016;45(8):1080-1082