Small Bowel Obstruction Due to Phytobezoars: Report of Four Cases and Literature Review

AbstractBezoars are concretions of indigestible foreign materials that develop within the gastrointestinal (GI) tract. A variety of materials received orally may form these masses. According to their composition, bezoars are classified as phytobezoars, which are the most frequent, trichobezoars, pharmacobezoars, lactobezoars, and other more rare entities. They are formed most frequently in the stomach and they may trigger serious symptoms, including dysphagia, abdominal pain, hematemesis, and intestinal obstruction or perforation. Contrast-enhanced computerized tomography (CT), in conjunction with GI endoscopy, has contributed substantially to the prompt and accurate diagnosis of these masses. Endoscopy also offers reliable therapeutic options, either through chemical disintegration of the bezoars or mechanical fragmentation and removal. The more serious cases of intestinal bezoars are usually treated surgically, either laparoscopically or via traditional laparotomy. This series describes four cases of intestinal phytobezoars that caused small bowel obstruction, and, in one case perforation, and were all treated surgically. Current advances in the diagnosis and treatment of bezoars are discussed and compared with the well-established methods.
Source: Hellenic Journal of Surgery - Category: Surgery Source Type: research