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At least 19 recordsLinked to original sources

PubMed1975

Yeast bezoar formation following gastric surgery.

Yeast bezoar seems to be a relatively common late complication after various gastric operations. The incidence of bezoar depends decisively on the nature of the operation. Vagotomy in particular is conducive to the formation of a bezoar. Vagotomy + Billroth I resection proveded the most propitious conditions for the growth of yeast, for every one-half of the patients in this group developed a bezoar. Yeast bezoars usually appear within a year of the operation. The majority disappear during the first follow-up year, many without any therapy. However, in some cases the bezoar was a rather inconvenient late complication of gastric surgery and one that gave symptoms. It is difficult to draw any definite conclusions concerning the effect of therapy on the disappearance of the bezoar. We used gastric lavage and antimycotics as well as substances that increase gastric acidity. There is still no known method of preventing the formation of yeast bezoars. In the present consensus, a change in the acid conditions and disturbed gastric motility postoperatively are conducive to the formation of a bezoar.

Adult↗

PubMedDate not supplied

[Treatment of the gastric bezoar by endoscopy].

This paper deals with our experiences in a group of patients with gastric bezoars who were treated endoscopically. A group of 7 patients, 5 women and 2 men, from 41 to 62 years of age, with the diagnosis of bezoar was studied. In 6 cases both the clinical and roentgenographic diagnosis was bezoar; in one case the diagnosis was not established before endoscopy. Endoscopic studies were performed to confirm the diagnosis and for treatment. The bezoars were fragmented, under endoscopic observation, with the biopsy mechanism and, after removal of the endoscope, gastric lavage was done through a 12 mm. tube for removal of the bezoar fragments. Postendoscopically all patients were given metoclopramide and new films were take at one week. Confirmation of complete removal of the bezoars was also obtained by subsequent endoscopic control. No complications were observed in any of the patients. We propose that endoscopic removal of bezoars is the treatment of choice because it lowers morbility, mortality and eliminates the need for surgery as well as lowering hospitalization time.

Adult↗

PubMed1992

Gastric surgery and bezoars.

We present a series of 56 patients with gastrointestinal bezoar following previous gastric surgery for gastroduodenal peptic ulcer. The following parameters were studied: factors predisposing to bezoar formation (type of previous surgery, alimentation, and mastication), form of clinical presentation, diagnostic tests, and treatment. A bilateral truncal vagotomy plus pyloroplasty had been performed previously on 84% of patients, 44% revealed excessive intake of vegetable fiber, and 30% presented with bad dentition. The most frequent clinical presentation was intestinal obstruction (80%). This was diagnosed mainly by clinical data and simple abdominal radiology. The main exploratory technique for diagnosing cases of gastric bezoar was endoscopy. Surgery is necessary for treating the intestinal forms, and one should always attempt to fragment the bezoar and milk it to the cecum, reserving enterotomy and extraction for cases where this is not possible. The small intestine and stomach should always be explored for retained bezoars. Gastric bezoars should always receive conservative treatment, endoscopic extraction, and/or enzymatic dissolution; gastrotomy and extraction should be performed when this fails.

Adult↗

PubMed1978

Gastric bezoars. A technique of endoscopic removal.

Gastric bezoar formation is an uncommon sequela of gastroduodenal surgery or unusual eating habits. Because they generally produce severe symptoms, their removal is always necessary. Previously, this required surgical extirpation or slow enzymatic dissolution. We present here an endoscopic procedure for bezoar removal utilized successfully in five patients with vegetable-mucus bezoars. This technique employs a jet spray of water under direct vision to mechanically disrupt the bezoar, which may then be removed using a large gastric lavage tube. This procedure is simple, safe, and rapid and is therefore recommended as an alternative to surgical removal or enzymatic dissolution of gastric bezoars.

Bezoars↗

PubMed1989

Gastric emptying and bezoars.

Bezoars are conglomerates of undigested material in the stomach, which appear as a late complication of gastric surgery and are presumably related to secondary motility changes. We studied the gastric emptying of a technetium-99m-(Tc 99m) labelled solid meal in 10 patients who presented with a bezoar 1 to 20 years after vagotomy and pyloroplasty, vagotomy and antrectomy, vagotomy and gastrojejunostomy, or hemigastrectomy. The results were compared with the emptying data of operated patients without bezoars. The gastric retention of Tc 99m-labelled solids at 45, 75, and 105 minutes was 85 +/- 15 percent (mean +/- SD), 79 +/- 17 percent, and 65 +/- 24 percent, respectively. No differences were found when results were compared with those of operated patients without bezoars. We concluded that factors other than the gastric digestive phase are the main contributors to bezoar formation.

Aged↗

PubMed1989

Pharmacological study of a traditional Chinese medicine: effect of bezoar bovis on the irregular beating pattern of cultured mouse myocardial cells.

The water-extract from "Bezoar bovis", a drug used in Chinese traditional medicine, was examined for its ability to alter the beating pattern of spontaneously contracting cultured embryonic mouse myocardial cells following changes in extracellular calcium (Ca2+). Incubation of the cells with medium containing low Ca2+ concentration (0.4 mM) caused the number of beating cells and beating rate to decrease and the number of arrhythmic cells to increase. By contrast, the number of beating cells decreased while beating rate and the number of arrhythmic cells increased at high Ca2+ (20 mM). Addition of Bezoar bovis extract to the medium attenuated the response to varying Ca2+ concentration. One of the major constituents of Bezoar bovis extract, taurine, was effective in protecting against the abnormal beating pattern induced by high Ca2+. Since beta-alanine, an inhibitor of taurine transport, antagonized the protective effects of both Bezoar bovis and taurine, it is likely that the effect of Bezoar bovis is partially mediated by taurine.

Alanine↗

PubMedDate not supplied

The fascinating history of bezoars.

The word "bezoar" is derived from the Arabic "bazahr" or "badzehr", which means antidote or counter-poison; animal bezoars were widely used in medicine until the 18th century. Trichobezoars (hair), phytobezoars (vegetable matter) or combinations of both (trichophytobezoars) may be found in the gastrointestinal tract of humans. While the prevalence of bezoars in humans is low, mortality rates may be as high as 30% if they remain untreated, mainly through gastrointestinal bleeding, destruction or perforation. Endoscopic treatment of gastric bezoars has made inroads into the traditional treatment of bezoars by surgical removal.

Bezoars↗

PubMed1990

Fungal bezoars of the upper urinary tract.

We report our experience with 6 cases of upper tract fungal bezoars involving 9 renal units-3 bilateral aspergillomas and 3 Candida bezoars. The Aspergillus bezoars were notably more morbid: 2 patients required nephrectomy after failure of medical therapy, whereas the 3 unilateral Candida bezoars all resolved with medical therapy and endourological access. In 1 patient whose aspergilloma was resistant to amphotericin B the investigational drug itraconazole proved effective. These opportunistic infections, seen increasingly in immunocompromised patients, can present a difficult management problem. A combined approach is necessary, including medical therapy with topical and systemic antifungal agents, and endourological access for extraction, lavage and debulking.

Adult↗

PubMed1991

Treatment of a gastric bezoar by extracorporeal shock wave lithotripsy.

A bezoar of the stomach was diagnosed by X-ray and endoscopy in an 8-year-old boy who presented with intermittent dull epigastric pain. Attempts at endoscopic extraction failed because of the size and hardness of the bezoar. Extracorporeal shock wave lithotripsy was therefore applied using ultrasound to locate the bezoar. Disintegration of the bezoar and spontaneous evacuation of the fragments was achieved.

Bezoars↗

PubMed1985

Bezoars--when the 'knot in the stomach' is real.

Bezoars, gastric or intestinal concretions of undigested fruit fibers, vegetable matter, or human hair, can cause acute obstruction or long-term interference with normal digestion and absorption of nutrients. Likelihood of bezoar formation is increased in patients who have undergone gastrointestinal surgery. In particular, patients who have had gastric reduction for morbid obesity may form a high-risk population. Certain diseases or medicines also can predispose to bezoar formation. Except in emergencies, when surgical removal is necessary, dissolution of bezoars by various enzymatic preparations is the currently accepted treatment.

Bezoars↗

PubMed1979

Management of persimmon bezoars (diospyrobezoars).

Since 1946, 20 men and one woman aged 40 to 76 years (average 57) were operated upon for complications of diospyrobezoars. Shortly after eating persimmons, 11 (52.4%) had severe abdominal cramping, anusea, vomiting, and pyrexia. Twelve of 17 (70.9%) with gastric bezoars had hematemesis or melena caused by an associated gastric ulcer, while five (29.1%) had only moderate dyspepsia. In four (19.1%), the bezoar had lodged in the ileum, causing obstruction. Enzymatic therapy is indicated in those with minor symptoms. Gastrotomy or gastrotomy with bezoar removal and wedge resection of the gastric ulcer is recommended when enzymatic therapy fails, or when there is gastric outlet obstruction or marrise hemorrhage. Emergency exploration with removal is necessary when the persimmon bezoar causes ileal obstruction.

Adult↗

PubMed1992

Cecal vitamin bezoar formation inducing abdominal discomfort.

OBJECTIVE: To document a case of cecal lecithin-vitamin B12 bezoar formation inducing abdominal discomfort. DESIGN: Case study. SETTING: 500-bed, community teaching hospital. PATIENT: 81-year-old man with a history of multiple abdominal surgeries who presented with a chief complaint of abdominal pain. Flat plate X-ray of the abdomen revealed multiple capsule-shaped objects lodged in the cecum. INTERVENTIONS: Catharsis with bisacodyl, magnesium citrate, NaCl 0.9%; dissolution with heated, dilute barium administered rectally in conjunction with external manipulation; laparotomy. MAIN OUTCOME MEASURES: None planned; dissolution or transit of bezoar through gastrointestinal tract desired outcome. RESULTS/DISCUSSION: Classification of bezoars and treatment discussed in relation to this case report. CONCLUSIONS: Medicinal agents have been implicated in bezoar formation. Treatment options have included: cathartics, heated solvent enemas, and external manipulation and surgery.

Abdominal Pain↗

PubMed1988

Bezoars: classification, pathophysiology, and treatment.

Bezoars, accumulations of foreign material in the stomach, have been known to occur in animals and man for centuries. The incidence of bezoars in human patients has increased as a result of operative manipulation of the gastrointestinal tract. Composed of vegetable matter, hair, or more unusual materials like shellac or cement, they may lead to anorexia, weight loss, bleeding, obstruction, or perforation of the alimentary tract. Although this entity is often recognized radiologically, endoscopy provides the most accurate means for identification and classification. Many bezoars can be removed endoscopically, but some will require operative intervention. Once removed, emphasis must be placed upon prevention of recurrence. Physicians must learn to recognize and classify bezoars correctly in order to provide the most appropriate therapy in each instance.

Bezoars↗

PubMed1987

Association of diabetes mellitus with gastric bezoar formation.

The association of diabetes mellitus with gastric bezoars is not well documented. Our endoscopic experience over a seven-year period (1979 to 1985) included 3247 esophagoduodenoscopies (EGDs). Bezoars were found in 14 patients (0.4%). The mean age of these 14 patients was 63 years (range, 27 to 84 years); there were eight men and six women. In 11 patients, there was a history and/or findings of peptic ulcer disease (PUD). Two patients had prior surgery (Billroth II in one and vagotomy in another). Seven patients had diabetes mellitus; five had diabetes for over five years, and three of these five had diabetes for over ten years. Diabetes was newly diagnosed in one patient. Except for the newly diagnosed patient, the other diabetic patients had evidence of autonomic neuropathy. Two other patients (not included with the diabetic patients) had hyperglycemia only during stress. The three patients with bezoars but without PUD all had diabetes for many years (9, 17, and 19 years). In two control groups of 14 patients each who also underwent endoscopy, only one diabetic patient was discovered. We conclude that diabetes mellitus and associated gastropathy are major risk factors for bezoar formation, especially in the absence of PUD.

Adult↗

PubMedDate not supplied

Gummi bear bezoar: a case report.

Bezoars in children are rare. Bezoars causing intestinal obstruction are even more unusual. We would like to report the first Gummi Bear Bezoar causing a large bowel obstruction in a child.

Bezoars↗

PubMed1989

Gastric bezoar: another side effect of endoscopic variceal sclerotherapy.

Gastric bezoars were observed after esophageal variceal injection of polidocanol in 5 of 56 patients with alcoholic cirrhosis treated by endoscopic sclerosis. We suggest that endoscopic sclerotherapy could have induced a transient vagal injury resulting in delayed gastric emptying and subsequent bezoar formation. Although the volume of sclerosant (25-35 ml per session) and the length of the injector needle (4 mm) were the same in all patients, two reasons could explain the occurrence of bezoars in these five patients: a deeper injection of sclerosant, and a worsening of a preexistent vagal neuropathy due to diabetes mellitus and/or alcoholism.

Adult↗

PubMedDate not supplied

[A case of phyto-mucous bezoar of the stomach].

A case of gastric phyto-mucous bezoar++ in an edentulous patient with chronic gastritis is reported. The effective medical treatment consisted of partial gastroscopic bezoar crumbling, gastric lavage with 1% sodium bicarbonate solution, and endoscopic removal of residual bezoar. The pathogenesis, symptoms, and treatment of gastric phytobezoars are discussed.

Aged↗

PubMed1990

Endoscopic lithotripsy of gastric bezoars using a laser-ignited mini-explosive device.

This paper reports the successful experiences of in vitro and in vivo studies on endoscopic fragmentation of gastric bezoars using a laser-ignited mini-explosive device. This new technique has been used clinically in 31 patients with gastric bezoars since January 1988. All patients were completely cured without any complication. The relationship between gastric bezoars and ulcers, and the technique of treatment were discussed.

Adolescent↗