Gastro-intestinal bezoars: thirty-five years experience.
OBJECTIVE
Because of their rarity and late diagnosis, gastro-intestinal bezoars can be treated after the occurrence of some complications such as acute intestinal obstruction, strangulation, decubitus ulceration and bleeding. In this study, reasons for bezoar formation, measures to be taken and treatment modalities were investigated.


METHODS
The files of the patients who were found to have gastro-intestinal bezoars and who were treated at Istanbul University, Cerrahpasa Medical Faculty General Surgery Department and Emergency Unit between the years 1970 and 2005 were analysed.


RESULTS
Thirteen (30%) of the 44 patients in the study were women, 31 (70%) were men: the mean age was 55.5 +/- 19.6 (range 22-96) years. Enzymatic dissolution (3 patients) and endoscopic fragmentation (four patients) were unsuccessful. Laparoscopic gastrotomy (n = 2), gastrotomy (n = 16), gastric resection (n = 3), enterotomy (n = 12), segmental intestinal resection (n = 3), gastroduodenotomy (n = 1), and gastrotomy + enterotomy (n = 3) were performed. In two patients, bezoars were fragmented and milked to caecum. There were no major postoperative complications, except abdominal wound infection in 4 patients and one patient who had a recurrent intestinal bezoar five years after the operation. One of the patients died because of heart failure on the 7th postoperative day. Mean hospital stay was 9.5 +/- 3.6 days.


CONCLUSIONS
Even though rarely seen in digestive tract diseases, the probability of BZ formation should always be remembered. After the removal of BZs by conservative methods or surgery, precautions should be taken against recurrence and possible underlying psychiatric disorders should be treated.
Ersoy
Y E
YE
Vakif Gureba Research and Training Hospital, II. General Surgery Clinic, Istanbul, Turkey. yelizemineersoy@yahoo.com
Ayan
F
F
Ayan
F
F
Ersan
Y
Y
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001630:Bezoars / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D015331:Cohort Studies; D013505:Digestive System Surgical Procedures; D004724:Endoscopy; D005260:Female; D041981:Gastrointestinal Tract; D006801:Humans; D007813:Laparotomy; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012997:Solvents; D055815:Young Adult
D012997:Solvents