Trichobezoar in a 13 year old Male: a case report and review of literature

Case report of a trichobezoar occuring in the stomach of a 13 year old boy known to suffer from trichotillomania. 90% of trichobezoars occur in adolescent females and the occurrence in males is rarely documented. The clinical presentation and complications of trichobezoars are discussed. Differential diagnosis of epigastric masses in children and the investigations utilised to diagnose these intragastric hairballs together with possible hypothses on their pathogenesis are discussed.peer-reviewe

New Surgical Approach for Gastric Bezoar: "Hybrid Access Surgery" Combined Intragastric and Single Port Surgery

Regarding the removal of a gastric bezoar, laparoscopic surgery was performed and it was shown that the laparoscopic approach is safe and feasible. However, the laparoscopic method has the risk of intraabdominal contamination, when the gastric bezoar is retrieved from the gastric lumen in the peritoneal cavity. We developed and applied a new procedure for the removal of the gastric bezoar using one surgical glove and two wound retractors as a fashion of intragastric single port surgery. Herein we present this new minimal invasive procedure, so named "hybrid access surgery" which involves the use of existing devices and overcomes the weakness of laparoscopic removal of the gastric bezoar. Our new procedure, combining the concept of intragastric and single port access, is acceptable and feasible to retrieve the gastric bezoar. In the future, this procedure may be one of the alternative procedures for retrieving gastric bezoar even when it is incarcerated in the pylorus

Giant gastric bezoar: A case report

Background: We report a case of gastric bezoar in a patient with underlying schizophrenia who presented with features mimicking gastric tumour in Federal Medical Centre (FMC), Keffi, Nigeria.Methods: This is a report of gastric bezoar who posed a diagnostic conundrum to the managing clinicians. Radiological investigation gave a lead point to the diagnosis and intra-operative finding eventually confirmed the diagnosis of gastric bezoar.Results: A huge gastric bezoar weighing 2,000g was found. This comprised of different components on nonbiodegradable materials.Conclusion: Diagnosis of gastric bezoar requires a high index of suspicion by the managing physicians especially in mentally unstable patients.Keywords: Gastric bezoar, Schizophrenia, Diagnosi

Bezoar-induced Small Bowel Obstruction

Purpose: The aim of this study was to observe the clinical features of a bezoar-induced small bowel obstruction and to in-vestigate the role of abdominal computed tomography (CT) in establishing the diagnosis. Methods: We retrospectively reviewed 20 cases of bezoar-induced small bowel obstruction in our hospital from 1996 to 2010. Results: Thirteen patients (65%) had a history of abdominal surgery. Nine patients (45%) were diagnosed with a bezoar before surgery, seven patients were diagnosed by using abdominal CT, and two patients were diagnosed with a small bowel series. Abdominal CT was performed in 15 patients, and the diagnostic accuracy was 47 % (7/15). Surgery revealed ten bezoars in the jejunum and 11 in the ileum. Two patients had bezoars found concurrently in the stomach. Spontaneous removal took place in two patients. An enterotomy and bezoar extraction was performed in 15 patients. Fragmentation and milking, a small bowel resection, and a Meckel’s diverticulectomy were performed in one patient each. Early operative treatment was possible (P = 0.036) once the bezoar had been diagnosed by using abdominal CT. There tended to be fewer postoperative complications in patients who were diagnosed with a bezoar by using abdominal CT, but the result was not statistically significant (P = 0.712). Conclusion: A preoperative diagnosis of bezoar-induced small bowel obstruction by using clinical features was difficult. Increased use of abdominal CT led to a more accurate diagnosis and to earlier surgery for bezoar-induced small bowel obstructions, thereby reducing the rate of complications

Bezoar: Imaging Findings & Case Study of a Rare Pathology

A bezoar is a hard, indigestible mass of material that forms within the alimentary canal, most commonly the stomach.1 Bezoars are classified according to composition. The most common type of bezoar is a phytobezoar composed of indigestible food fibers that occur in fruits & vegetables, including celery, pumpkin, prunes, raisins, & sunflower-seed shells. Other common types of bezoars include trichobezoars, composed of hair, & pharmacobezoars, made of undissolved medications. A number of risk factors have been associated with bezoar development. Patients who have undergone gastric surgery, such as partial gastrectomy, are at an increased risk of developing a bezoar due to delayed gastric emptying, decreased stomach size, or reduced stomach acid production. Other risk factors include diabetes mellitus, end-stage kidney disease, cystic fibrosis, intrahepatic cholestasis, & psychiatric illness.2,3 This poster will present the rare finding of a large duodenal bezoar.https://digitalcommons.unmc.edu/cahp_mits_pres/1002/thumbnail.jp

Trichobezoar: Case Report and Literature Review

A bezoar is an agglomeration of food or foreign material in the intestinal tract usually noticed in ruminants. It can be classified as trichobezoar (hair) or phytobezoar (plant material). Stomach is the commonest site for bezoar formation, which may result in obstruction, gastric wall ulceration andmalnutrition. They present with abdominal pain, small bowel obstruction or malnutrition. Trichobezoars are associated with trichotillomania. This is a case report of trichobezoar in a Sudanese girl who presented with abdominal pain. This to our knowledge is the first case to be reported from Sudan.Key words: Bezoar, Trichobezoar, Trichotillomania, Sudan

Bezoars: diagnosis, management, and potential complications in patients with psychiatric disorders

Word "bezoar" comes from Persian "pâdzahr," which means "antidote," since, in ancient times, it was believed that bezoar could cure and nullify effects of all poisons. In medical context, bezoar is the term used for conglomerates of undigested material that accumulate in de gastrointestinal tract. Case of 60-year-old female patient with repeated episodes of intestinal obstruction associated with digestive tract bleeding. She presented to emergency department with severe abdominal pain and intolerance to oral route. Computed tomography identified hypodense image suggestive of a oreign body in the small bowel  lumen. During laparotomy, stone-like mass of approximately 3×5 cm was found at level of jejuno-ileal junction, 80 cm from Treitz ligament, with presence of an intestinal flange that conditions rotation of the intestinal loop on its axis. Intestinal obstruction due to bezoar is uncommon in adult patients, and symptoms are usually non-specific. It requires a high index of suspicion and effective screening for trichotillomania. In such cases, imaging studies such as tomography help to establish the diagnosis.

BEZOARI U KOLEKCIJI TÁVORA SEQUEIRA PINTO U OPORTU (PORTUGAL)

Bezoar stones, once used as universal antidotes and panaceas, but currently regarded as costly and useless medicines of the past, are a major milestone in the history of toxicology. Arabic physicians had been using bezoars in medicine from the 8th century onwards. In the 16th century, the Portuguese controlled bezoar trade from India, and the Portuguese doctors Garcia de Orta, Amatus Lusitanus, and Cristobal Acosta introduced the medicinal use of Oriental bezoars to European medical literature. Some criticism aside, leading European doctors prescribed bezoars mainly as powerful antidotes. Five bezoars that now adorn the Távora Sequeira Pinto Collection in Oporto testify to the allure and glory of bezoars at the height of their golden age, when they equalled the splendour of gems and noble minerals that dominated the Eastern and Western lithotherapy. The end of the 18th century marked the end of ancient panaceas. This article focuses on the therapeutic and apotropaic use of bezoars.Bezoari – nekad univerzalni protuotrov i panaceja, a danas smatrani skupim i beskorisnim lijekom iz prošlosti – imaju su značajno mjesto u povijesti toksikologije. Arapski su liječnici rabili bezoare u medicinske svrhe još od 8. stoljeća. U 16. stoljeću, kad su trgovinu bezoarima držali Portugalci, liječnici Garcia de Orta, Amatus Lusitanus i Cristobal Acosta predstavili su europskoj medicini primjenu istočnjačkih bezoara u terapeutske svrhe. Zanemare li se određene kritike, vodeći su europski liječnici bezoare mahom propisivali kao snažne protuotrove. Pet izložaka iz kolekcije Távora Sequeira Pinto u Oportu svjedoči o privlačnosti i slavi bezoara na vrhuncu njihova zlatnog doba, kada su po cijenjenosti bili izjednačeni s dragim kamenjem i mineralima rabljenim u istočnjačkoj i zapadnoj litoterapiji. Kraj XVIII. stoljeća donio je i kraj primjene antičkih panaceja. Ovaj je članak posvećen terapijskim i apotropaičnim primjenama bezoara

Postoperative bezoar ileus after early enteral feeding

Postoperative enteral nutrition is a widely accepted route of application for nutrition formulas due to a low complication rate, a good acceptance by patients. and a favorable cost-effectiveness. We report three cases of bezoar ileus after early postoperative enteral nutrition, using a fine needle jejunostomy (FNJ) in two cases and a nasoduodenal tube in one case. A male patient who underwent gastric resection for a gastrointestinal stroma tumor and was nourished through an fine needle jejunostomy developed an acute abdomen on the seventh postoperative day. Surgical exploration revealed a mechanical ileus caused by denaturated nutrition formula distal to the catheter tip. The second case, a female patient, underwent gastric resection for a gastric cancer and on the fourth postoperative day developed acute onset of abdominal pain. Intraoperative findings were the same as described in the first case. The third case, a male patient with necrotizing cholecystitis, underwent open cholecystectomy. Postoperative enteral feeding was performed using a nasoduodenal tube. He developed a small bowel obstruction on the 17th postoperative day that was caused by an intraluminal bezoar. In conclusion, bezoar formation represents an underestimated complication of postoperative enteral feeding. Acute onset of abdominal pain and the development of small bowel obstruction are the main clinical symptoms of this severe complication. The pathogenesis of bezoar formation remains unclea