Type:
Educational Exhibit
Keywords:
Abdomen, Gastrointestinal tract, CT, Surgery, Foreign bodies, Obstruction / Occlusion
Authors:
G. Çakmak1, K. Özdemir2, M. Y. Uzunoğlu3, F. Altintoprak4; 1Sakarya/TR, 2Sakarya, Turkey/TR, 3Siirt/TR, 4İstanbul/TR
DOI:
10.26044/ecr2019/C-3696
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 jejenum (n=35-28.7%),
stomach (n=27-22.5%),
and duodenum(n=3-2%).
Surgical operations [milking (n=62),
enterotomy (n=29),
gastrotomy (n=12),
gastrotomy+milking (n=10),
gastrotomy+ enterotomy (n=9)] were performed. Seventy nine of one hundred twenty two (64.7%) patients who underwent previous abdominal surgery due to peptic ulcers had multiple bezoars.
Twenty three (18.8%) patients had diabetes mellitus (DM; type I,
n=4; type II, n=19).
Thirteen patients (10.6%) had incomplete dentition,
with missing partial or whole posterior teeth. Seven patients (0.5%) had no surgical history,
diabetes mellitus or incomplete dentition.
Common CT findings in all patients were a mottled gas pattern and a focal ovoid or round intraluminal mass with regular margins and a heterogeneous internal structure.