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. 2012 Apr;28(2):89-93.
doi: 10.3393/jksc.2012.28.2.89. Epub 2012 Apr 30.

Bezoar-induced Small Bowel Obstruction

Se Heon Oh  1 , Hwan Namgung, Mi Hyun Park, Dong-Guk Park
Affiliations

Bezoar-induced Small Bowel Obstruction

Se Heon Oh et al. J Korean Soc Coloproctol. 2012 Apr.

Abstract

Purpose: The aim of this study was to observe the clinical features of a bezoar-induced small bowel obstruction and to investigate the role of abdominal computed tomography (CT) in establishing the diagnosis.

Methods: We retrospectively reviewed 20 cases of bezoar-induced small bowel obstruction in our hospital from 1996 to 2010.

Results: Thirteen patients (65%) had a history of abdominal surgery. Nine patients (45%) were diagnosed with a bezoar before surgery, seven patients were diagnosed by using abdominal CT, and two patients were diagnosed with a small bowel series. Abdominal CT was performed in 15 patients, and the diagnostic accuracy was 47% (7/15). Surgery revealed ten bezoars in the jejunum and 11 in the ileum. Two patients had bezoars found concurrently in the stomach. Spontaneous removal took place in two patients. An enterotomy and bezoar extraction was performed in 15 patients. Fragmentation and milking, a small bowel resection, and a Meckel's diverticulectomy were performed in one patient each. Early operative treatment was possible (P = 0.036) once the bezoar had been diagnosed by using abdominal CT. There tended to be fewer postoperative complications in patients who were diagnosed with a bezoar by using abdominal CT, but the result was not statistically significant (P = 0.712).

Conclusion: A preoperative diagnosis of bezoar-induced small bowel obstruction by using clinical features was difficult. Increased use of abdominal CT led to a more accurate diagnosis and to earlier surgery for bezoar-induced small bowel obstructions, thereby reducing the rate of complications.

Keywords: Bezoars; Computed tomography; Small intestine, Intestinal obstruction.

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Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1
Fig. 1
Monthly incidence of bezoar-induced small bowel obstruction.
Fig. 2
Fig. 2
Diagnostic algorithm of bezoar-induced small bowel obstruction. CT, computed tomography; US, ultrasound; SBS, small bowel series; Dx, diagnosis.
Fig. 3
Fig. 3
Abdominal computed tomography scan shows a well-defined mass with mottled gas pattern within the transitional zone of the small bowel: (A) axial view and (B) coronal view.
See this image and copyright information in PMC

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