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. 2021 Jan;49(1):300060520979377.
doi: 10.1177/0300060520979377.

Clinical characteristics and indications for surgery for bezoar-induced small bowel obstruction

Shuai Wang  1 , Xiaohui Yang  1 , Yixiong Zheng  1 , Yulian Wu  1
Affiliations

Clinical characteristics and indications for surgery for bezoar-induced small bowel obstruction

Shuai Wang et al. J Int Med Res. 2021 Jan.

Abstract

Background: To evaluate the clinical characteristics and indications for surgery for bezoar-induced small bowel obstruction (BI-SBO).

Methods: Forty patients with BI-SBO were treated at our hospital from January 2017 to December 2019, and these patients' clinical and computed tomography (CT) data were analyzed.

Results: Twenty-seven and 13 BI-SBO patients constituted the non-ST group and ST group, respectively. The clinical manifestations of BI-SBO in both groups were abdominal pain, nausea, vomiting, and lack of defecation. Comparing the non-ST vs ST groups, respectively: mean age (years): 63.15 ± 16.15 vs 60.38 ± 12.47; duration of symptoms (hours): 55.11 ± 44.08 vs 59.33 ± 72.90; mean bezoar length (cm): 5.31 ± 0.74 vs 3.72 ± 0.53; mean bezoar width (cm): 3.74 ± 0.48 vs 2.9 ± 0.64; bezoar CT maximum Hounsfield units (HU): 97.23 ± 12.36 vs 21.11 ± 7.27; total hospital stay (days): 5.56 ± 4.23 vs 7.12 ± 6.12 (mean: 8.62 ± 2.81); and total hospitalization costs (RMB): 6378.02 ± 3015.68 vs 8213.71 ± 5564.29. Mean operation time was 85.00 ± 8.90 minutes, and mean operation blood loss was 32.31 ± 19.64 mL. Bezoars were located 60 to 160 cm from the ileocecal junction. Univariate analysis demonstrated that bezoar length and width and maximum CT value were significant risk factors for surgery.

Conclusion: Large bezoar size and high CT values may be indications for surgery. Surgery is necessary and effective when nonsurgical treatment is ineffective.

Keywords: Bezoar-induced small bowel obstruction; clinical characteristics; computed tomography; hospital stay; hospitalization costs; surgical indications.

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Conflict of interest statement

Declaration of conflicting interest: The authors declare that there is no conflict of interest.

Figures

Figure 1.
Figure 1.
Radiologic appearances of the bezoars in CT planar scans. CT, computed tomography.
See this image and copyright information in PMC

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