Gastric phytobezoar associated with impaired gastric motility in a patient with spinal cord injury.
Impaired gastrointestinal motility as a result of interruption of sympathetic outflow is a common occurrence in the spinal cord injury (SCI) population. In addition, frequent use of medications with anticholinergic properties in this population results in further impairment of peristalsis resulting in gastrointestinal stasis. Since SCI patients often lack sensation below the level of injury, they may present with vague symptoms, which complicates the diagnosis of intestinal obstruction. We report the first case of gastric phytobezoar in a patient with T4 ASIA A paraplegia who presented with vague upper abdominal discomfort, anorexia, weight loss, and vomiting. Because mortality rates can be as high as 30% if phytobezoars remain untreated, gastrointestinal phytobezoars should be considered in the differential diagnosis of abdominal discomfort in SCI patients. Etiologic factors for phytobezoars are discussed for the general population and in particular, for patients with SCI.
Nambiar
Prabhakaran K
PK
Spinal Cord Injury and Diseases Unit, Department of Veterans Affair Medical Center, Richmond, Virginia 23249, USA. Pknambiar@netzero.net
Midha
Meena
M
Schmitt
James K
JK
D001630:Bezoars / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology*; D005769:Gastrointestinal Motility / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D013119:Spinal Cord Injuries / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology*; D013270:Stomach / Q000000981:diagnostic imaging / Q000503:physiopathology*