The Clinical Analysis of 25 Cases of Bezoars

ABSTRACT

PURPOSE: Bezoars are defined as retained concretions of animal or vegetable material in the gastrointestinal tract, and can be classified as trichobezoar, phytobezoar, trichophytobezoar or concretion. The purpose of this study was to review and analyze 25 cases of bezoar. METHODS: The medical records of 25 patients, treated between February 1995 and November 2004, were reviewed. The clinical characteristics, as well as the diagnostic evaluations and results of surgical treatment, were also analyzed retrospectively. RESULTS: Of the 25 patients, 13 men and 12 women, the bezoars were in the stomach, ileum or in both the stomach and ileum in 17, 5 and 2 cases, respectively, with 1 case in the esophagus. Bezoars are usually caused by an altered gastric physiology, with impaired gastric emptying as a result of surgery, such as subtotal gastrectomy, antrectomy or truncal vagotomy with pyloroplasty. The treatment of bezoars depends on their composition and location. A gastric bezoar can be treated by endoscopic removal, although not all cases can be completely removed. Small bowel bezoars are usually discovered on exploration due to an intestinal obstruction, with surgical removal being the standard treatment method in such cases. CONCLUSION: A bezoar occurs mainly in patients who have previously undergone a gastric operation. Surgeons should keep in mind the possibility of bezoars in patients presentingan intestinal obstruction following a past gastric operation. The treatment principle for bezoars used to be surgery, but recently gastric bezoars are often treated by gastrofiberscopy.