title: Clinical characteristics and treatment outcomes of nineteen Japanese patients with gastrointestinal bezoars.
abstract: OBJECTIVE
  To analyze the clinical characteristics of patients with gastrointestinal bezoars and their response to therapy. Patients We retrospectively reviewed the cases of 19 patients diagnosed with gastrointestinal bezoars at the Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences or one of 15 collaborating institutions between December 2004 and August 2013. We investigated the epidemiology and etiology of the gastrointestinal bezoars by determining the gender, age at diagnosis, medical history, symptoms, complications, modalities used for diagnosis, treatments, outcomes and bezoar location, color and contents.
  
  
  RESULTS
  There were 17 patients with gastric bezoars and two patients with small intestinal bezoars. All patients were 62 years of age or older, except for one case of a trichobezoar in a 10-year-old patient. Some of the patients had a history of surgery of any part of the gastrointestinal tract (n=5) and/or diabetes mellitus (n=2). The two patients with small intestinal bezoars required surgical removal in order to relieve ileus. Approximately one-half of the patients with gastric bezoars had ulcerations in the stomach (9/17 patients, 52.9%) and/or gastrointestinal bleeding (8/17, 47.1%). Endoscopic fragmentation was performed in 10 patients, whereas bezoar dissolution was achieved with a gastroprokinetic agent (n=1) and without any treatment (n=3) in the remaining cases.
  
  
  CONCLUSIONS
  As previously reported, elderly individuals with a positive history of surgery and/or diabetes mellitus were observed in this bezoar patient series. Gastric ulcers and gastrointestinal bleeding were frequently observed. The majority of patients underwent endoscopic fragmentation, while spontaneous resolution of the gastric bezoar was observed in several cases.
authors.affiliation: Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Japan.
authors.forename: Masaya
authors.initials: M
authors.lastname: Iwamuro
authors.forename: Shouichi
authors.initials: S
authors.lastname: Tanaka
authors.forename: Junji
authors.initials: J
authors.lastname: Shiode
authors.forename: Atsushi
authors.initials: A
authors.lastname: Imagawa
authors.forename: Motowo
authors.initials: M
authors.lastname: Mizuno
authors.forename: Shigeatsu
authors.initials: S
authors.lastname: Fujiki
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Toyokawa
authors.forename: Yuko
authors.initials: Y
authors.lastname: Okamoto
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Murata
authors.forename: Yoshinari
authors.initials: Y
authors.lastname: Kawai
authors.forename: Daisuke
authors.initials: D
authors.lastname: Tanioka
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Okada
authors.forename: Kazuhide
authors.initials: K
authors.lastname: Yamamoto
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001630:Bezoars / Q000209:etiology / Q000473:pathology* / Q000628:therapy; D002648:Child; D048909:Diabetes Complications; D005260:Female; D005746:Gastric Emptying; D006471:Gastrointestinal Hemorrhage / Q000209:etiology; D006801:Humans; D045823:Ileus / Q000150:complications / Q000628:therapy; D007421:Intestine, Small; D007564:Japan; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013270:Stomach; D013276:Stomach Ulcer / Q000209:etiology; D016896:Treatment Outcome