Oropharyneal Bezoar in a Patient with Amyotrophic Lateral Sclerosis under Mechanical Ventilation: A case report / 대한구급학회지

ABSTRACT

Bezoars are not uncommonly found during upper gastrointestinal investigations (UGI), are known to be associated with conditions causing stasis changes in gastrointestinal tract. We described here a curious presentation of an oropharyngea bezoar associated with medication and tube feeding. Only few cases of regurgated esophageal bezoar have been reported. A 54 years old man with amyotropic lateral sclerosis required ventilatory support. Nasogastric tube was placed, enteral feeding with special liquid diet (Geenvia TF) was begun. In addition, almagate was given via the feeding tube. Tracheotomy was done for long term mechanical ventilation support. On the 10th day of ICU stay, he complained of foreign body sensation in oral cavity. We could find a white brown colored 15cm solid mass in deep oropharynx. Some factors including sucralfate and the peripheral neuropathy have been suspected to be ascribed forming the esophageal bezoar. Gastrointestinal motility was decrease in patients with peripheral neuropathy. In this case, aluminum hydroxides, one of the aluminium substance like sucralfate, was given to the patient with the peripheral neuropathy. From this experience, we became to know that it is necessary to use the aluminium compound anti-ulcer drug with caution in the patients with the gastrointestinal depression.