title: Gastric surgery and bezoars.
abstract: 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.
authors.affiliation: University of Murcia, Virgen de la Arrixaca Hospital, Department of General Surgery, El Palmar, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Cifuentes Tebar
authors.forename: R
authors.initials: R
authors.lastname: Robles Campos
authors.forename: P
authors.initials: P
authors.lastname: Parrilla Paricio
authors.forename: J A
authors.initials: JA
authors.lastname: Lujan Mompean
authors.forename: C
authors.initials: C
authors.lastname: Escamilla
authors.forename: R
authors.initials: R
authors.lastname: Liron Ruiz
authors.forename: E M
authors.initials: EM
authors.lastname: Pellicer Franco
mesh_terms: D000328:Adult; D000368:Aged; D001630:Bezoars / Q000453:epidemiology / Q000209:etiology* / Q000401:mortality; D004064:Digestive System; D004198:Disease Susceptibility; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010437:Peptic Ulcer / Q000601:surgery; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology* / Q000401:mortality; D012189:Retrospective Studies; D013030:Spain / Q000453:epidemiology; D013270:Stomach / Q000601:surgery*