title: Synergistic effect of multiple predisposing risk factors on the development of bezoars.
abstract: OBJECTIVE
  To describe the clinical characteristics of patients with gastric or intestinal bezoars recently treated in our hospital.
  
  
  METHODS
  In this study, a retrospective chart review of consecutive patients with gastrointestinal bezoars, who were treated at the Samsun Education and Research Hospital between January 2006 and March 2011, was conducted. Data on demographic characteristics, clinical presentation, history of risk factors, diagnostic procedures, localization of bezoars, treatment interventions, and postoperative morbidity and mortality rates were collected and evaluated.
  
  
  RESULTS
  Forty-two patients [26 (61.9%) males and 16 (31.1%) females] with a mean ± SD (range) age of 55.8 ± 10.5 (37-74) years were enrolled in this study. Thirty-six patients (85.7%) had one or more predisposing risk factors for gastrointestinal bezoars. The most common predisposing risk factor was a history of previous gastric surgery which was identified in 18 patients (42.8%). Twenty three patients (54.8%) had multiple predisposing risk factors. Phytobezoars were identified in all patients except one who had a trichobezoar in the stomach. Non-operative endoscopic fragmentation was performed either initially or after unsuccessful medical treatment in 14 patients with gastric bezoars and was completely successful in 10 patients (71.5%). Surgery was the most frequent treatment method in our study, which was required in 28 patients (66.7%). Intestinal obstruction secondary to bezoars was the most common complication (n = 18, 42.8%) in our study.
  
  
  CONCLUSIONS
  The presence of multiple predisposing factors may create a synergistic effect in the development of bezoars.
authors.affiliation: Department of General Surgery, Samsun Education and Research Hospital, Samsun 55000, Turkey. mkement@yahoo.com
authors.forename: Metin
authors.initials: M
authors.lastname: Kement
authors.forename: Nuraydin
authors.initials: N
authors.lastname: Ozlem
authors.forename: Elif
authors.initials: E
authors.lastname: Colak
authors.forename: Sadik
authors.initials: S
authors.lastname: Kesmer
authors.forename: Cem
authors.initials: C
authors.lastname: Gezen
authors.forename: Selahattin
authors.initials: S
authors.lastname: Vural
mesh_terms: D000328:Adult; D000368:Aged; D000818:Animals; D001630:Bezoars / Q000209:etiology* / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors