Gastrointestinal bezoars: A retrospective analysis of 34 cases

Table 1 Predisposing factors and coincidental diseases of the patients.

Predisposing factors1 (n = 32)	n	%
Previous gastric surgery (n = 19)		55.88
Truncal vagotomy+pyloroplasty	9	26.47
Distal subtotal gastrectomy (or antrectomy)+	9	26.47
Billroth II anastomosis
Truncal vagotomy + Billroth II anastomosis	1	2.94
Peptic ulcus	4	11.76
Diabetes mellitus	4	11.76
Cherrylaurel (Prunus Buricerasus) or
Persimmon (Diospyrus Lotus) intakes	6	17.64
Mental retardation-trichotillomania	2	5.88
High dose intake of H2 receptor antagonists	1	2.94
Total	36
Coincidental diseases (n = 14)2	2	41.17
Diabetes mellitus	4	11.76
Mental retardation	2	5.88
Hypertension	4	11.76
Cardiac and coronary artery diseases	5	14.7
Chronic pulmonary disease	3	8.82
Parkinson’s disease	1	2.94
Behcet’s disease	1	2.94
Cerebro-vascular disease	1	2.94
Abdominal aortic aneurysm	1	2.94
Strangulated incisional hernia	1	2.94
Total	23

¹Four patients had 2 predisposing factors and 2 patients had none.

²Five patients had two or more diseases.

Table 2 Locations of BZ.

	n	%
Number
1	26	76.47
2	6	17.64
3	1	2.94
4	1	2.94
Localisation
Stomach	15	44.11
Duodenum	1	2.94
Jejunum	4	11.76
Ileum	8	25.32
Stomach+jejunum	2	5.88
Stomach+ileum	3	8.82
Jejunum-ileum	1	2.94
Phytobezoar	32	94.11
Trichobezoar	2	5.88

Table 3 Diagnostic procedures in the study.

	n	%
Plain abdominal graphy (n = 32)
Gastric nonhomogenous mass	2	6.25
Intestinal air and air-fluid levels	16	50
Ultrasonography (n = 10)
Intestinal dilatation and wall thickeness	10	100
Hyperechogenous gastric mass	1	10
Barium studies (n = 13)
Filling defect in stomach or small intestines	11	84.61
(One of them diagnosed as bezoar)
CT-scan (n = 8)
Dilated intestinal loops	6	75
Intraluminal masses with gas bubbles and hypodense areas
-Stomach	2	25
-Duodenum	1	12.25
-Duodenum+jejunum	1	12.25
Endoscopy (n = 16) Bezoar is seen	13	81.25

Table 4 Morbidity and mortality in this study.

	n	%
Morbidity
Wound infection	5	14.7
Wound dehiscence	1	2.94
Incisional hernia	2	5.88
Intraabdominal bleeding	1	2.94
Failure in endoscopic treatment	1	2.94
Total	10	29.41
Mortality: Due to sepsis and multiple organ failures	4	11.76

Table 5 Objectivies of mortality.

Age (yr) and sex	Coincidental disease	Localization of bezoar	Complication	Postoperative day of death
70 M	No	Ileum with perforation	No	Early postoperative death
63 M	Cardiac arrhythmia	Ileum	Intraabdominal bleeding	10
50 M	Diabetes mellitus	Ileum		5
70 F	Wound dehiscence	Duodenum	Evantration	28

Table 6 Morbidity and mortality rates according to the subgroups.

	Morbidity	%	Morbidity	%
SBO (n = 18)
Total
Intraabdominal bleeding	71	38.88	31	16.66
Wound dehiscence	1
Wound infection	4
	1
Incisional hernia
Non-SBO group (n = 16)
Total
Wound infection	31	18.75	11	5.55
Failure of endoscopic procedure	1
Incisional hernia	1
Surgery treatment (n = 28)	91		41
Endoscopy (n = 7)	11		1
(Failure in endoscopic procedure)

¹P>0.05 (Fisher’s exact test).