1/21. Laparosopic removal of large gastric phytobezoars.Large gastric bezoars are difficult to remove endoscopically. A 78-year-old man presenting with abdominal pain and loss of appetite for 4 months was admitted and evaluated. gastroscopy disclosed two large phytobezoars within the stomach. Laparoscopic removal was undertaken. The bezoars were removed via a gastrotomy using the three-trocar technique. They were successfully retrieved from the abdominal cavity using an improvised "endobag" made from a simple surgical glove. Such an endobag presents several advantages; they are easy to make, sterile, economical, readily available, disposable, there is ample space to manipulate the specimen within, and there is minimal risk of contamination throughout the procedure. The authors recommend this approach for the treatment of patients with large gastric bezoars in whom laparotomy is indicated.- - - - - - - - - - ranking = 1keywords = abdominal pain (Clic here for more details about this article) |
2/21. An intragastric trichobezoar: computerised tomographic appearance.A 26-year-old lady presented with a history of abdominal pain and distension since two months. The ultrasound examination showed an epigastric mass, which was delineated as a filling defect in the stomach on barium studies. The computerised tomographic scan showed a gastric mass with pockets of air in it, without post-contrast enhancement. This case highlights the characteristic appearance on computerised tomography of a bezoar within the stomach, a feature that is not commonly described in medical literature.- - - - - - - - - - ranking = 1keywords = abdominal pain (Clic here for more details about this article) |
3/21. Gastric trichobezoar: an important cause of abdominal pain presenting to the pediatric emergency department.abdominal pain is a common presenting complaint of children seen in urgent care settings. It is the manifestation of a wide variety of disease processes ranging from benign to immediately life-threatening. Gastric bezoars are among the etiologies of chronic childhood abdominal pain that, when undiagnosed, may result acutely in serious complications, including gastric ulceration, bleeding and perforation, intussusception, and small bowel obstruction. To reinforce the importance of including this entity in the differential diagnosis of abdominal pain, we present the case of a 10-year-old girl with a history of chronic epigastric complaints who was ultimately presented with acute small bowel obstruction following fragmentation and distal migration of her gastric trichobezoar. Finally, we review and briefly summarize the current literature regarding the etiology, diagnosis, and management of this disorder in children.- - - - - - - - - - ranking = 6keywords = abdominal pain (Clic here for more details about this article) |
4/21. Phytobezoars as a cause of small bowel obstruction associated with a carcinoid tumor of the ileocecal area.Carcinoid tumors are slowly growing malignant neoplasms associated with an indolent clinical course. About 60% of such tumors are located within the gastrointestinal tract. We describe an unusual case of small bowel obstruction associated with a carcinoid tumor of the ileum. A 70-year-old woman was presented with abdominal pain, vomiting, and clinical signs of mechanical bowel obstruction. X-ray and CT-scan of the abdomen showed hydroaeric levels and the presence of intraluminal hyperdense "stones", presumably of gallbladder origin. A diagnostic laparotomy revealed that a large part of the terminal ileus was edematous, with prominent evidence of intestinal loop adhesions. The edematous part of the ileum was resected. Incision of the intestinal wall revealed a 2-cm soft mass at 8 cm from the ileocecal valve, where the presence of ten fruit pits obstructed the intestinal cavity. Histopathological examination confirmed the diagnosis of a carcinoid tumor. An interesting case of small-bowel obstruction with a double cause is presented: an ileal carcinoid and fruit pit bezoars. The pathophysiology of the obstruction is discussed.- - - - - - - - - - ranking = 1keywords = abdominal pain (Clic here for more details about this article) |
5/21. An unusual etiology of epigastric mass.Bezoar is described as presence of indigested or poorly digested material forming a mass in the gastrointestinal lumen. patients may present with abdominal pain, dyspeptic complaints, gastrointestinal obstruction, perforation or bleeding, as well as, incidental abdominal mass in asymptomatic patients. We report a 30-year-old female patient with no history of previous illness who was presented to the emergency ward with complaints of epigastric pain and abdominal bloating. The diagnostic features and treatment of bezoar are presented.- - - - - - - - - - ranking = 1keywords = abdominal pain (Clic here for more details about this article) |
6/21. Cecal vitamin bezoar formation inducing abdominal discomfort.OBJECTIVE: To document a case of cecal lecithin-vitamin B12 bezoar formation inducing abdominal discomfort. DESIGN: Case study. SETTING: 500-bed, community teaching hospital. PATIENT: 81-year-old man with a history of multiple abdominal surgeries who presented with a chief complaint of abdominal pain. Flat plate X-ray of the abdomen revealed multiple capsule-shaped objects lodged in the cecum. INTERVENTIONS: catharsis with bisacodyl, magnesium citrate, NaCl 0.9%; dissolution with heated, dilute barium administered rectally in conjunction with external manipulation; laparotomy. MAIN OUTCOME MEASURES: None planned; dissolution or transit of bezoar through gastrointestinal tract desired outcome. RESULTS/DISCUSSION: classification of bezoars and treatment discussed in relation to this case report. CONCLUSIONS: Medicinal agents have been implicated in bezoar formation. Treatment options have included: cathartics, heated solvent enemas, and external manipulation and surgery.- - - - - - - - - - ranking = 1keywords = abdominal pain (Clic here for more details about this article) |
7/21. Laparoscopic removal of a large gastric bezoar in a mentally retarded patient with pica.Whereas small gastric bezoars may be removed endoscopically, large bezoars traditionally are removed at laparotomy. We describe a 33-year-old mentally retarded woman with pica syndrome who had experienced episodes of upper abdominal pain and distension of 10 months duration. gastroscopy showed a large bezoar in the stomach, and attempted endoscopic removal was unsuccessful. The patient underwent laparoscopic extraction of the bezoar, which proved to be an ingested glove. She made an uneventful recovery and was discharged home on postoperative day 1. She had no wound complications, and her symptoms had not recurred at a 3-month follow up assessment. The operative technique is described, and the merits of the laparoscopic approach are discussed.- - - - - - - - - - ranking = 1keywords = abdominal pain (Clic here for more details about this article) |
8/21. Gastric bezoar caused by lecithin: an unusual complication of health faddism.We discovered an unusual bezoar in a previously healthy man who had been ingesting large amounts of a vegetable-derived oil touted to contain lecithin, which he purchased from health food stores in the belief that it had beneficial effects in lowering cholesterol levels and improving memory. The large intragastric mass, composed of fatty acids and lecithin, led to considerable morbidity, including abdominal pain, early satiety, and significant weight loss, and required surgical removal.- - - - - - - - - - ranking = 1keywords = abdominal pain (Clic here for more details about this article) |
9/21. Large gastric trichobezoar in a normal healthy woman: case report and review of pertinent literature.This report presents a unique case of a gastric trichobezoar in a relatively healthy, young female with no history of psychological or psychiatric disorders. Furthermore, unlike previously reported cases, this patient had no history of gastric surgery. The mode of presentation and the difficulties in diagnosis are discussed. The different modalities of treatment, both surgical and nonsurgical, are evaluated and discussed. The diagnosis of a trichobezoar in a healthy patient requires a high index of suspicion, as it can present with nonspecific symptomatology. It should be included in the differential diagnosis of nonspecific abdominal pain.- - - - - - - - - - ranking = 1keywords = abdominal pain (Clic here for more details about this article) |
10/21. Huge gastric diospyrobezoars successfully treated by oral intake and endoscopic injection of coca-cola.A diospyrobezoar is a type of phytobezoar that is considered to be harder than any other types of phytobezoars. Here, we describe a new treatment modality, which effectively and easily disrupted huge gastric diospyrobezoars. A 41-year-old man with a history of diabetes mellitus was admitted with lower abdominal pain and vomiting. Upper gastrointestinal endoscopy revealed three huge, round diospyrobezoars in the stomach. He was made to drink two cans of coca-cola every 6 h. At endoscopy the next day, the bezoars were partially dissolved and turned to be softened. We performed direct endoscopic injection of coca-cola into each bezoar. At repeated endoscopy the next day, the bezoars were completely dissolved.- - - - - - - - - - ranking = 1keywords = abdominal pain (Clic here for more details about this article) |
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