WorldWideScience

Sample records for bezoars

  1. Medication bezoar: Intestinal obstruction by an Isocal bezoar

    International Nuclear Information System (INIS)

    Medications may occasionally obstruct the gastrointestinal tract by virtue of their physical mass. Obturative obstruction of the alimentary tract is reportedly caused by an increasing number of medications, including hydroscopic bulk laxatives, cholestyramine, nonabsorbable antacids, and vitamin C tablets. Inspissated Isocal tube feedings caused jejunal obstruction in a postoperative patient. Medication bezoars are a rare cause of intestinal obstruction that may result in significant patient morbidity, including bowel necrosis, perforation, and peritonitis. The radiographic appearance may mimic an abdominal abscess. (orig.)

  2. A Literary Study on Bezoar Bovis

    Directory of Open Access Journals (Sweden)

    Seong Kyu Park

    2005-12-01

    Full Text Available Objectives : Literary investigation of existing data was conducted to verify effects of Bezoar Bovis and its herbal acupuncture, and determine quality management through component analysis. Results : Following results were obtained through literary investigation. 1. Bezoar Bovis is dried cystic stone from a cattle. Its characteristics are cool, no toxicity, and bitter taste. Known actions are: quells heat and detoxifies Fire Poison, extinguishes internal movement of Liver Wind and stops convulsion, vaporizes phlegm, and opens orifice. It is mainly used for treating tremor, stroke, delirium, sore throat, oral furuncle, boil, and others. 2. Bezoar Bovis is effective for eliminating liver toxicity, protecting against brain damage, and has anti-microbial activities. 3. Bezoar Bovis is mixed with bear gall bladder and deer musk to be used as herbal acupuncture, and this mixture is effective is invigorating liver functions as well as treating arthritis, headache, and etc. 4. Principal components of Bezoar Bovis are bilirubin-type pigments and cholic acids. The amount of bilirubin can be used as a standard to determine the quality of Bezoar Bovis.

  3. A Case of Asymptomatic Bezoar Incidentally Found on Intravenous Pyelogram

    Directory of Open Access Journals (Sweden)

    Büyükkaya R et al.

    2009-09-01

    Full Text Available Bezoars are intraluminal masses in the gastrointestinal tract that develop by collection of undigested materials. Though bezoars are usually located in the stomach, they also develop in the small intestines and cause mechanical intestinal obstructions there. Patients with bezoars usually present with intestinal obstruction. According to present literature data patients are asymptomatic and there is no bezoar case reported that was incidentally discovered. The bezoar of the present case was diagnosed with sonography and computed tomography, after a non-homogenous radioopacity was discovered in the right lower quadrant by an IVP investigation that was done due to recurrent urinary tract infection.

  4. Review of the diagnosis and management of gastrointestinal bezoars.

    Science.gov (United States)

    Iwamuro, Masaya; Okada, Hiroyuki; Matsueda, Kazuhiro; Inaba, Tomoki; Kusumoto, Chiaki; Imagawa, Atsushi; Yamamoto, Kazuhide

    2015-04-16

    The formation of a bezoar is a relatively infrequent disorder that affects the gastrointestinal system. Bezoars are mainly classified into four types depending on the material constituting the indigestible mass of the bezoar: phytobezoars, trichobezoars, pharmacobezoars, and lactobezoars. Gastric bezoars often cause ulcerative lesions in the stomach and subsequent bleeding, whereas small intestinal bezoars present with small bowel obstruction and ileus. A number of articles have emphasized the usefulness of Coca-Cola(®) administration for the dissolution of phytobezoars. However, persimmon phytobezoars may be resistant to such dissolution treatment because of their harder consistency compared to other types of phytobezoars. Better understanding of the etiology and epidemiology of each type of bezoar will facilitate prompt diagnosis and management. Here we provide an overview of the prevalence, classification, predisposing factors, and manifestations of bezoars. Diagnosis and management strategies are also discussed, reviewing mainly our own case series. Recent progress in basic research regarding persimmon phytobezoars is also briefly reviewed. PMID:25901212

  5. Duodenal obstruction following acute pancreatitis caused by a large duodenal diverticular bezoar

    Institute of Scientific and Technical Information of China (English)

    Ji Hun Kim; Jae Hyuck Chang; Sung Min Nam; Mi Jeong Lee; Il Ho Maeng; Jin Young Park; Yun Sun Im

    2012-01-01

    Bezoars are concretions of indigestible materials in the gastrointestinal tract.It generally develops in patients with previous gastric surgery or patients with delayed gastric emptying.Cases of periampullary duodenal divericular bezoar are rare.Clinical manifestations by a bezoar vary from no symptom to acute abdominal syndrome depending on the location of the bezoar.Biliary obstruction or acute pancreatitis caused by a bezoar has been rarely reported.Small bowel obstruction by a bezoar is also rare,but it is a complication that requires surgery.This is a case of acute pancreatitis and subsequent duodenal obstruction caused by a large duodenal bezoar migrating from a periampullary diverticulum to the duodenal lumen,which mimicked pancreatic abscess or microperforation on abdominal computerized tomography.The patient underwent surgical removal of the bezoar and recovered completely.

  6. Acute small bowel obstruction due to chicken bone bezoar

    Directory of Open Access Journals (Sweden)

    Vetpillai P

    2012-12-01

    Full Text Available Preadeepan Vetpillai,1 Ayo Oshowo21CT2 Surgery in General, Charing Cross Hospital, 2Colorectal and Laparoscopic Surgery, Whittington Hospital, London, UKAbstract: Acute intestinal obstruction due to foreign bodies, or bezoar, is a rare occurrence in an adult with a normal intestinal tract. We report an unusual case of a 43-year-old black man with no previous abdominal surgery and no significant medical history who presented with an acute episode of small bowel obstruction due to an impacted undigested chicken bone.Keywords: small bowel obstruction, chicken bone, bezoar

  7. Acute small bowel obstruction due to chicken bone bezoar

    OpenAIRE

    Vetpillai P; Oshowo A

    2012-01-01

    Preadeepan Vetpillai,1 Ayo Oshowo21CT2 Surgery in General, Charing Cross Hospital, 2Colorectal and Laparoscopic Surgery, Whittington Hospital, London, UKAbstract: Acute intestinal obstruction due to foreign bodies, or bezoar, is a rare occurrence in an adult with a normal intestinal tract. We report an unusual case of a 43-year-old black man with no previous abdominal surgery and no significant medical history who presented with an acute episode of small bowel obstruction due to an impacted u...

  8. Perforated duodenal diverticulum caused by Bezoar: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Eun Jung; Moon, Sung Kyoung; Park, Seong Jin; Lim, Joo Won; Lee, Dong Ho; Ko, Young Tae [Dept. of Radiology, College of Medicine, Kyung Hee University, Seoul (Korea, Republic of)

    2013-11-15

    Duodenal diverticulum is common, but its perforation is a rare complication. Duodenal diverticulum perforation requires prompt treatments because of its high mortality rate. However, an accurate diagnosis is difficult to make due to nonspecific symptoms and signs. It can be misdiagnosed as pancreatitis, cholecystitis, or peptic ulcer. Herein, we report a case of perforated duodenal diverticulum caused by bezoar in a 33-year-old woman whom was diagnosed by abdomen computed tomography and ultrasonography.

  9. Oesophageal bezoar as a complication of enteral nutrition in critically ill patients. Two case studies.

    Science.gov (United States)

    Gil-Almagro, Fernanda; Carmona-Monge, Francisco Javier

    2016-02-01

    Enteral nutrition has a relatively low incidence of major complications. The most common complications are mechanical problems, bronchoaspiration and diarrhoea. A rare complication associated with the use of enteral nutrition is oesophageal bezoar. A bezoar is a body of undigested and partially digested matter in the gastrointestinal tract. The main risks factors are gastric motility dysfunction and the use of opiates or sucralfate. The aim of this paper was to present two cases of oesophageal obstruction resulting from the formation of bezoars due to enteral nutrition. Both patients experienced prolonged stays in the intensive care unit and were receiving enteral nutrition, and both cases involved an obstruction of the nasogastric tube and the regurgitation of solid chunks of enteral nutrition through the mouth and the nose. Impactions of solidified enteral nutrition in the distal parts of the oesophagus were confirmed with gastroscopies. Enzymatic complexes containing papain, cellulose, pancreatin, pepsin and diastase were used to successfully dissolve the bezoars in both cases. PMID:26531231

  10. An unusual cause of small bowel obstruction in children: lentil soup bezoar

    OpenAIRE

    Plataras, Christos; Sardianos, Nektarios; Vlatakis, Stephanos; Nikas, Konstantinos

    2014-01-01

    Bezoars are an unusual cause of acute intestinal obstruction in children. Most cases are trichobezoars in adolescent girls who swallow their hair. Lactobezoars are another unusual but occasionally reported cause of intestinal obstruction in neonates. Phytobezoars and food bolus bezoars are the least common types of intestinal obstruction that have been reported in children. Of the few paediatric cases that have been described, the majority involve persimmons. Moreover, all of these cases invo...

  11. Development of bile duct bezoars following cholecystectomy caused by choledochoduodenal fistula formation: a case report

    Directory of Open Access Journals (Sweden)

    Adibnejad Soheil

    2006-01-01

    Full Text Available Abstract Background The formation of bile duct bezoars is a rare event. Its occurrence when there is no history of choledochoenteric anastomosis or duodenal diverticulum constitutes an extremely scarce finding. Case presentation We present a case of obstructive jaundice, caused by the concretion of enteric material (bezoars in the common bile duct following choledochoduodenal fistula development. Six years after cholecystectomy, a 60-year-old female presented with abdominal pain and jaundice. Endoscopic retrograde cholangiopancreatography demonstrated multiple filling defects in her biliary tract. The size of the obstructing objects necessitated surgical retrieval of the stones. A histological assessment of the objects revealed fibrinoid materials with some cellular debris. Post-operative T-tube cholangiography (9 days after the operation illustrated an open bile duct without any filling defects. Surprisingly, a relatively long choledochoduodenal fistula was detected. The fistula formation was assumed to have led to the development of the bile duct bezoar. Conclusion Bezoar formation within the bile duct should be taken into consideration as a differential diagnosis, which can alter treatment modalities from surgery to less invasive methods such as more intra-ERCP efforts. Suspicions of the presence of bezoars are strengthened by the detection of a biliary enteric fistula through endoscopic retrograde cholangiopancreatography. Furthermore, patients at a higher risk of fistula formation should undergo a thorough ERCP in case there is a biliodigestive fistula having developed spontaneously.

  12. [Esophageal bezoar resulting from nasogastric enteral feeding in an intensive care unit].

    Science.gov (United States)

    Lartigue, C; Karayan, J; Beau, P; Kaffy, F

    2001-04-01

    We report two cases of oesophageal bezoar in patients given enteral nutrition by nasogastric tubing in an intensive care unit. These two complications occurred during the year following the replacement of our standard enteral feed by a new preparation enriched in proteins. In both patients, the bezoar could be endoscopically removed. The enteral feeding solution is likely to be responsible for the development of this complication because no other factor known to favour this complication such as concomitant administration of sulfacrate or anti-acid agents was given to the patients; and the bezoar developed shortly after the new enteral feeding solution was used, a hypothesis supported by several similar case reports in the medical literature. PMID:11392248

  13. Plastic bezoar in the terminal ileum: a case report and imaging findings; Plastibezoar no ileo terminal: relato de caso e aspectos de imagem

    Energy Technology Data Exchange (ETDEWEB)

    Oliveira, Gabriel Antonio de; Abikair Filho, Jorge [Hospital Infantil Nossa Senhora da Gloria, Vitoria, ES (Brazil); Werlang, Henrique Zambenedetti [MedImagem, Sao Paulo, SP (Brazil)]. E-mail: hzwerlang@gmail.com; Bergoli, Pedro Martins [SIDI - Servico de Investigacao Diagnostica, RS (Brazil)

    2006-04-15

    A 2 year old child presented with persistent abdominal pain and was referred to imaging studies. The abdominal ultrasound showed a hyper echogenic mass in the abdomen. Computed tomography scan showed a mass with very unusual density in the distal ileum. The patient was submitted to laparotomy and a large plastic bezoar was removed. In the medical literature, stomach bezoar, especially trichobezoar is a well known and described finding. No other case of plastic bezoar has been reported in similar imaging studies in the literature reviewed.(author)

  14. Radiation sterilization for determination of micro-organisms D10 value and for effect of bezoar detoxification powder

    International Nuclear Information System (INIS)

    Four types of micro-organisms (B. pumilus E601, S. aureus, B. pyocyaneus and B. coli) were exposed to 60Co γ-radiation, and D10 values were determined. Results indicate that D10 values were 2.1, 0.17, 0.07 and 0.08 kGy, respectively for the four types of organisms. At 10 kGy levels of treatment Bezoar detoxification powder, the number of micro-organisms is zero

  15. Gastric electrical stimulation for the treatment of obesity: from entrainment to bezoars-a functional review.

    Science.gov (United States)

    Mintchev, Martin P

    2013-01-01

    GROWING WORLDWIDE OBESITY EPIDEMIC HAS PROMPTED THE DEVELOPMENT OF TWO MAIN TREATMENT STREAMS: (a) conservative approaches and (b) invasive techniques. However, only invasive surgical methods have delivered significant and sustainable benefits. Therefore, contemporary research exploration has focused on the development of minimally invasive gastric manipulation methods featuring a safe but reliable and long-term sustainable weight loss effect similar to the one delivered by bariatric surgeries. This antiobesity approach is based on placing external devices in the stomach ranging from electrodes for gastric electrical stimulation to temporary intraluminal bezoars for gastric volume displacement for a predetermined amount of time. The present paper examines the evolution of these techniques from invasively implantable units to completely noninvasive patient-controllable implements, from a functional, rather than from the traditional, parametric point of view. Comparative discussion over the available pilot and clinical studies related to gastric electrical stimulation outlines the promises and the fallacies of this concept as a reliable alternative anti-obesity strategy. PMID:23476793

  16. Radiation sensitivity of microorganisms adhering to the crude drug ''Bezoar Bovis'' and stability of its main components for γ-ray irradiation

    International Nuclear Information System (INIS)

    The sterilization dose (SD) of γ rays required for the microbial-contaminated crude drug ''Bezoar Bovis'' and the residual rates of its characteristic and effective components, bilirubin and some kinds of cholic acid, were studied experimentally. Samples of Bezoar Bovis made in America were used. The contamination level of the samples was 2.2 x 108 cells of bacteria and 6.0 x 105 spores of fungi per g specimen. The survival rate of these microorganisms showed nearly an exponential dependence on radiation dose. The decimal reduction doses (D10) for the bacteria and fungi were found to be 1.5 kGy and 1.1 kGy respectively. From these values, the dose required for attaining the contamination level provided by the administrative guidance (Bacteria, 3 cells/g; Fungi, 2 spores/g) were estimated to be 7.5 kGy and 4.3 kGy, respectively. The G-values for bilirubin, cholic acid and deoxycholic acid were calculated to be 13, 6 and 8, respectively. If the sterilization treatment is carried out with a dose less than 10 kGy on the specimen in a dry powder state, the reduction of the main components such as bilirubin and cholic acids by γ-ray irradiation is considered to be negligible. (author)

  17. Curative Effect Observation of Bezoar Sedative Pill on Preventing and Treating Pediatric Febrile Convulsion%牛黄清心丸防治小儿热性惊厥疗效观察

    Institute of Scientific and Technical Information of China (English)

    魏勇

    2013-01-01

    Objective:To investigate the clinical effect of the therapy of Bezoar Sedative Pill on children with febrile convulsion.Methods:60 children with febrile convulsion participated in the study.30 cases were randomly assigned into therapy group (Bezoar Sedative Pill add conventional therapy) and 30 cases were in controlled group (conventional therapy).All patients were followed up for one year after discharge.During follow up,children in treatment group were given oral antipyretics add Bezoar Sedative Pill when they got fever again; while children in controlled group were given oral antipyretics alone when they got fever.Then the time of continued fever during hospital and the cases of recurrent febrile convulsion within one year after discharge were compared between the two groups.Results:The time of continued fever of patients in therapy group during hospital was significantly shorter than those in controlled group (P<0.05),and the cases of recurrent febrile convulsion in therapy group within one year after discharge was significantly less than recurrent cases in controlled group (P<0.05).Conclusion:Bezoar Sedative Pill can shorten the time of continued fever during hospital and decreases the cases of recurrent febrile convulsion within one year after discharge.%目的:观察牛黄清心丸辅助治疗小儿热性惊厥的疗效.方法:选取热性惊厥患儿60例,随机分为牛黄清心丸治疗组和对照组各30例,两组均给予常规治疗,治疗组加用口服牛黄清心丸(3g/天,3~5天).出院后所有患儿随访1年.随访期间患儿如再次出现发热,治疗组予口服退热药加牛黄清心丸(3g/天,3~5天),对照组仅口服退热药.比较两组住院期间发热持续时间、出院后1年内各组热性惊厥复发病例数.结果:治疗组患儿住院期间发热持续时间较对照组缩短,两组间比较有统计学意义(P<0.05);随访1年期间,治疗组热性惊厥复发例数低于对照组,两组

  18. 高效液相色谱法测定氨咖黄敏胶囊的含量%Determination in Paracetamol Caffein Artificial Cow-Bezoar and Chlorphenamine Maleate Capsules by HPLC

    Institute of Scientific and Technical Information of China (English)

    吴俊芳; 张涛; 李丽萍

    2011-01-01

    Objective To establish a HPLC method for simultaneously determining paracetamol and caffiene in Paracetamol Caffein Artificial Cow-Bezoar and Chlorpbenamine Maleate Capsules. Methods The analytical column was Aglient C18(250 mm ×4. 6 mm, 0. 5 μm) with the column temperature of 30 ℃. The mobile phase was 1% acetic acid (adjusting to pH 3. 7 with ethylenediamine)-methanol(60:40) with flow rate of 1.0 mL/min. The detection wavelength was set at 272 nm. Results The linear ranges of paracetanol and caffeine were 0.1222-3. 055 5 μg and 0. 007 482 - 0. 187 1 μg with the relative coefficient r = 1. 000 0, r = 1. 000 0 ( n = 6), respectively. The average recovery rates of paracetamol and caffeine were 99. 54% ( RSD =0.66% )and 100.43% ( RSD =0. 92% ), respectively. Conclusion The method is simple, rapid, accurate and reliable, which can be used for the quality control of Paracetamol Caffein Artificial Cow- Bezoar and Chlorpbenamine Maleate Capsules.%目的 建立同时测定氨咖黄敏胶囊中对乙酰氨基酚和咖啡因含量的高效液相色谱法.方法 色谱柱为Aglient C18柱(250 mm×4.6 mm,5μm),流动相为1%醋酸溶液(用乙二胺调Ph至3.7)-甲醇(60:40),流速为1.0 Ml/min,检测波长272 nm,柱温30℃.结果 对乙酰氨基酚、咖啡因进样量分别在0.122 2~3.055 5μg和0.007 482~0.1871μg范围内与峰面积呈良好线性关系,r分别为1.000 0和1.000 0(n=6),平均加样回收率分别为99.54%(RSD=0.66%)和100.43%(RSD=0.92%).结论 该方法快速简便、准确可靠,可用于氨咖黄敏胶囊的质量控制.

  19. 1.4%Sodium Bicarbonate Retention Enema on Scavenging Channel Bezoars in Contrast to Digest%1.4%的碳酸氢钠保留灌肠清除小儿下消化道粪石对比研究

    Institute of Scientific and Technical Information of China (English)

    谢立新

    2014-01-01

    Objective To investigate the 1.4% sodium bicarbonate retention enema on road bezoar clear under the ef ect of digestion in children. Methods 70 patients in our department from 2012 January to selection method in 2013 December during hospitalization as evaluation object, Were randomly divided into experimental group and control group, two groups were given conventional anti infection,Spectrum ir adiation for two times a day to promote intestinal peristalsis, The experimental group adopted the first 1.4%sodium bicarbonate retention enema for half an hour after reflux enema once a day, The control group adopted reflux enema once a day, to compare the treatment ef ect of the two groups. Results The experimental group remove bezoar is bet er than the control group, The experimental group of independent defecation time earlier than the control group ( <0.5). Conclusion Sodium bicarbonate retention enema for half an hour after reflux enema than simple reflux enema can accelerate the bezoar ileus bezoar discharge, Reduce the bezoar ileus complications, reduce the conservative treatment is invalid for the incidence of operation, Shorten the hospitalization time, improve the cure rate of bezoar ileus.%目的探讨1.4%的碳酸氢钠保留灌肠对清除小儿下消化道粪石的效果。方法选取我科2012年1月~2013年12月期间住院的70例患儿作为评估对象,随机分为实验组及对照组,两组均给予常规抗感染,频谱仪照射2次/d促进肠蠕动,实验组采取先1.4%的碳酸氢钠保留灌肠30min后再回流灌肠1次/d,对照组采取回流灌肠1次/d,对两组的治疗效果进行对比分析。结果实验组清除粪石的效果优于对照组,实验组自主排便的时间早于对照组﹙<0.5﹚。结论碳酸氢钠保留灌肠30min后再回流灌肠比单纯回流灌肠更能加快粪石性肠梗阻的粪石排出,降低粪石性肠梗阻的并发症的发生,减少因保守治疗无效需做手术的发病率,缩短住院时间,提

  20. Rektal bezoar forårsaget af solsikkekerner

    DEFF Research Database (Denmark)

    Thing, Birthe Agergaard; Jørgensen, Henrik

    2010-01-01

    Phytobezoar is a rare cause of colonic obstruction in Denmark. We describe a case of a 12-year-old boy who was admitted to the hospital because he had not passed stool in two days and complained of anal pain. The boy had consumed about 200 grams of salted sunflower seeds with shells two days before...

  1. Drug: D06721 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available D06721 Crude, Drug Oriental bezoar (JP16); Powdered oriental bezoar (non-JP) Biliru...attle family) Oriental bezoar Major component: Bile acid [CPD:C01558] Powdered product: Standards for non-ph

  2. Intussusception caused by dried apricot: A case report

    Directory of Open Access Journals (Sweden)

    Yana Puckett

    2014-01-01

    CONCLUSION: Bezoars are an extremely rare cause of intussusception in adults. A high level of suspicion needs to exist in the presence of a history of eating dried fruit, history of gastric surgery, diabetes mellitus, and problems with mastication. Various treatment modalities exist to treat obstructions secondary to bezoars, including open reduction and removal of bezoar via enterotomy.

  3. Ventrikelbezoar forårsaget af bariumsulfat

    DEFF Research Database (Denmark)

    Nielsen, Marie Kristina Rue; Ewertsen, Caroline; Hillingsø, Jens Georg

    2012-01-01

    We present the first case of a gastric bezoar caused by barium sulphate acting as an intermittently occluding mass in a patient who had undergone small bowel follow-through on suspicion of small bowel obstruction (SBO) after total pancreatectomy. The patient underwent acute surgery but intermittent...... symptoms of SBO persisted. A barium bezoar was seen on plain abdominal film and afterwards diluted and fragmented gastroscopically. A barium bezoar giving rise to SBO is a possible complication to barium follow-through in patients with impaired gastric transit time....

  4. [Two cases of phytobezoars treated by adminsitration of Coca-Cola by oral route].

    Science.gov (United States)

    Lee, Hyun Jai; Kang, Hyoun Goo; Park, Se Young; Yi, Chea Yong; Na, Gyoung Jun; Lee, Tae Yeong; Kim, Sang Hyun; Song, Chul Soo

    2006-12-01

    Bezoars are concretions of foreign bodies found in the gastrointestinal tract. In the past, most common method for the treatment of bezoar was surgical management. However, the current treatment methods include chemical dissolution and endoscopic mechanical lithotripsy. There were few reports on the treatment of phytobezoars by nasogastric Cola lavage. However, there was no report succeeded by oral route alone. In our two cases, phytobezoars were treated by oral administration of Coca-Cola. Our patients drank 700-800 mL of Coca-Cola daily, and after two months, complete dissolutions of bezoars were achieved. We report two cases of phytobezoars completely treated by drinking Coca-Cola. PMID:17189928

  5. Environ: E00093 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available taurus [TAX:9913] Same as: D06721 Bovidae (Cattle family) Oriental bezoar Major component: Bile acid [CPD:C01558] Powdered product: Standards for non-pharmacopoeial crude drugs ...

  6. Review of the diagnosis and management of gastrointestinalbezoars

    Institute of Scientific and Technical Information of China (English)

    Masaya Iwamuro; Hiroyuki Okada; Kazuhiro Matsueda; Tomoki Inaba; Chiaki Kusumoto; Atsushi Imagawa; Kazuhide Yamamoto

    2015-01-01

    The formation of a bezoar is a relatively infrequentdisorder that affects the gastrointestinal system.Bezoars are mainly classified into four types dependingon the material constituting the indigestible mass of thebezoar phytobezoars, trichobezoars, pharmacobezoars,and lactobezoars. Gastric bezoars often cause ulcerativelesions in the stomach and subsequent bleeding,whereas small intestinal bezoars present with smallbowel obstruction and ileus. A number of articles haveemphasized the usefulness of Coca-Cola? administrationfor the dissolution of phytobezoars. However, persimmonphytobezoars may be resistant to such dissolutiontreatment because of their harder consistency comparedto other types of phytobezoars. Better understanding ofthe etiology and epidemiology of each type of bezoarwill facilitate prompt diagnosis and management.Here we provide an overview of the prevalence, classification,predisposing factors, and manifestations ofbezoars. Diagnosis and management strategies arealso discussed, reviewing mainly our own case series.Recent progress in basic research regarding persimmonphytobezoars is also briefly reviewed.

  7. A rare cause of mechanical intestinal obstruction: Pharmacobezoar

    Science.gov (United States)

    Erdemir, Ayhan; Ağalar, Fatih; Çakmakçı, Metin; Ramadan, Saime; Baloğlu, Hüseyin

    2015-01-01

    A bezoar is a hard, and solid, foreign body located in the gastrointestinal tract that may recur. Bezoar is classified according to its origin. Pharmacobezoars develop in the gastrointestinal tract due to alterations in anatomical structure and/or intestinal motility. In this paper, a case, not yet defined in the literature, of a pharmacobezoar causing a mechanical obstruction that is accompanied by a malignancy in the colon is reported, with the aim of contributing to the literature. PMID:26170758

  8. Phytobezoar in a jejunal diverticulum as a cause of small bowel obstruction: a case report

    Directory of Open Access Journals (Sweden)

    Rauf Fozia

    2011-09-01

    Full Text Available Abstract Introduction Phytobezoars are concretions of poorly digested fruit and vegetable fibers found in the alimentary tract. Previous gastric resection, gastrojejunostomy, or pyloroplasty predispose people to bezoar formation. Small-bowel bezoars normally come from the stomach, and primary small-bowel bezoars are very rare. They are seen only in patients with underlying small-bowel diseases such as diverticula, strictures, or tumors. Primary small-bowel bezoars almost always present as intestinal obstructions, although it is a very rare cause, being responsible for less than 3% of all small-bowel obstructions in one series. Jejunal diverticula are rare, with an incidence of less than 0.5%. They are usually asymptomatic pseudodiverticula of pulsion type, and complications are reported in 10% to 30% of patients. A phytobezoar in a jejunal diverticulum is an extremely rare presentation. Case presentation A 78-year-old Pakistani man presented to our clinic with small-bowel obstruction. Upon exploration, we found a primary small-bowel bezoar originating in a jejunal diverticulum and causing jejunal obstruction. Resection and anastomosis of the jejunal segment harboring the diverticulum was performed, and our patient had an uneventful recovery. Conclusion Primary small-bowel bezoars are very rare but must be kept in mind as a possible cause of small-bowel obstruction.

  9. Extração de fitobezoar gástrico por videolaparoscopia: considerações técnicas originais Videolaparoscopic extraction of gastric phytobezoar: original technical aspects

    Directory of Open Access Journals (Sweden)

    Carlos Eduardo Domene

    2002-08-01

    Full Text Available Videolaparoscopic surgery has been used for treatment of almost all surgical abdominal diseases, mainly where there are no large ressections, or operative field is limited. In these situations, laparoscopic surgery has the advantages of less morbidity, quick recovery and good cosmetic results. Bezoars removal, or its mobilization, is probably included in these possible proceedings. Three non-laparotomic procedures were described: 1. endoscopic-laparoscopic; 2. videolaparoscopy and mobilization of intestinal bezoar to the cecum; 3. laparoscopy and gastrotomy for bezoar removal, through suprapubic incision or the umbilical punction. There have been only two publications describing the videolaparoscopic method for bezoar removal, and the methods applied can be complications or morbidity related. We describe one case where the applied technique is simple and easy to perform, time saving and probably less complications-related. This technique, with four trocars, utilized a plastic bag besides the stomach to be opened, followed by gastrotomy, bezoar removal and immediate introduction in the plastic bag, suture of gastrotomy and removal through the left subcostal trocar. This technique was feasible and easy to perform, with short operative time, and there were no intra or post-operative complications; the patient was discharged in the second post-operative day, and is without further problems after one year follow-up. We believe that this could be an adequate technique to perform laparoscopic gastric bezoar removal, and the rigid sequence of operative events allows a quick procedure, with minimal contamination. The videolaparoscopy seems to be an adequate access to surgical treatment of gastro-intestinal bezoars, with or without obstruction, and should be the ellected the procedure of choice to begin the surgical treatment, with convertion to laparotomy in case of any intra-operative adversity.

  10. Efferent limb of gastrojejunostomy obstruction by a whole okra phytobezoar: Case report and brief review

    Directory of Open Access Journals (Sweden)

    Thant Zin

    2012-01-01

    Full Text Available A phytobezoar is one of the intraluminal causes of gastric outlet obstruction, especially in patients with previous gastric surgery and/or gastric motility disorders. Before the proton pump inhibitor era, vagotomy, pyloroplasty, gastrectomy and gastrojejunostomy were commonly performed procedures in peptic ulcer patients. One of the sequelae of gastrojejunostomy is phytobezoar formation. However, a bezoar causing gastric outlet obstruction is rare even with giant gastric bezoars. We report a rare case of gastric outlet obstruction due to a phytobezoar obstructing the efferent limb of the gastrojejunostomy site. This phytobezoar which consisted of a whole piece of okra (lady finger vegetable was successfully removed by endoscopic snare. To the best of our knowledge, this is the first case of okra bezoar-related gastrojejunostomy efferent limb obstruction reported in the literature.

  11. Mechanical colonic obstruction secondary to core of the pomegranate

    Directory of Open Access Journals (Sweden)

    Akın Önder

    2011-09-01

    Full Text Available Bezoars are often common in people with mental retardation and psychiatric disease, a condition that requires surgical intervention. Bezoar is retained concretions of ingested plant or animal materials that accumulate within the gastrointestinal tract. They often form in the stomach and can pass into the small intestine and cause obstruction, rarely leads to perforation. Fitobezoar phenomenon is common all over the world, is one of a rare cause of large bowel obstruction. In this study we report a case of colonic obstruction due to accumulation of edible pomegranates seeds. Fourteen-year-old boy admitted with diagnosis of acute abdomen dependind on ileus to the emergency department were operated. Fytobezoar fully obstructing the lumen of the sigmoid colon was found. Bezoar removed and end colostomy was performed. The patient was discharged after surgery without complication. In children, psychiatric patients, and patients with a history of gastrointestinal surgery in cases of intestinal obstruction differential diagnosis should include bezoars. J Clin Exp Invest 2011; 2 (3: 315-318.

  12. Gastric trichobezoar: Food for thought

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    Narisha Maharaj

    2013-03-01

    Full Text Available A bezoar is an agglomeration of food or indigestible foreign material in the gastro-intestinal tract. It is an uncommon cause of abdominal symptomatology and can result in intestinal obstruction. This report is of an adolescent girl with a history of abdominal distension and trichophagia.

  13. Gastric trichobezoar: Food for thought

    OpenAIRE

    Narisha Maharaj; Pumersha Naidoo; Vanesha Naidu; Jaynund Maharajh

    2013-01-01

    A bezoar is an agglomeration of food or indigestible foreign material in the gastro-intestinal tract. It is an uncommon cause of abdominal symptomatology and can result in intestinal obstruction. This report is of an adolescent girl with a history of abdominal distension and trichophagia.

  14. A Huge Gastric Trichobezoar in a Teenage Girl

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    Seyed Mohammad Vahid Hosseini

    2009-12-01

    Full Text Available A 13-year-old girl presented with a history of not being wellduring the past six months. The ultrasound examinationshowed an epigastric mass, which was diagnosed as a bezoarwithin the stomach in upper gastrointestinal endoscopy. Thepatient was managed by operative evacuation. It was interestingthat such a large bezoar did not cause any significant obstructionfor the patient.

  15. How good is cola for dissolution of gastric phytobezoars?

    Institute of Scientific and Technical Information of China (English)

    Beom Jae Lee; Jong-Jae Park; Hoon Jai Chun; Ji Hoon Kim; Jong Eun Yeon; Yoon Tae Jeen; Jae Seon Kim; Kwan Soo Byun; Sang Woo Lee; Jae Hyun Choi; Chang Duck Kim; Ho Sang Ryu; Young-Tae Bak

    2009-01-01

    AIM: To evaluate the efficacy of cola treatment for gastric phytobezoars, including diospyrobezoars. METHODS: A total of 17 patients (range: 48 to 78 years) with symptomatic gastric phytobezoars treated with cola and adjuvant endoscopic therapy were reviewed. Three liters of cola lavage (10 cases) or drink (7 cases) were initially used, and then endoscopic fragmentation was done for the remnant bezoars by using a lithotripsy basket or a polypectomy snare. The overall success of dissolving a gastric phytobezoars with using three liters of cola and the clinical and endoscopic findings were compared retrospectively between four cases of complete dissolution by using only cola and 13 cases of partial dissolution with cola. RESULTS: After 3 L of cola lavage or drinking, a complete dissolution of bezoars was achieved in four patients (23.5%), while 13 cases (76.5%) were only partially dissolved. Phytobezoars (4 of 6 cases) were observed more frequently than diospyrobezoars (0 of 11) in the group that underwent complete dissolution ( P = 0.006). Gender, symptom duration, size of bezoar and method of cola administration were not significantly different between the two groups. Twelve of 13 patients with residual bezoars were completely treated with a combination of cola and endoscopic fragmentation. CONCLUSION: The rate of complete dissolution with three liters of cola was 23.5%, but no case of diospyrobezoar was completely dissolved using this method. However, pretreatment with cola may be helpful and facilitate endoscopic fragmentation of gastric phytobezoars.

  16. Candida dubliniensis encrustation of an obstructing upper renal tract calculus

    OpenAIRE

    O'Kane, Dermot; Kiosoglous, Anthony; Jones, Kay

    2013-01-01

    We present the case of a 53-year-old man, with a history of alcohol abuse, requiring intensive care unit admission, with an obstructing right upper renal calculus and Klebsiella pneumoniae urosepsis. Ureteroscopic treatment of this obstruction displayed a small calculus within the renal pelvis completely encapsulated within a fungal bezoar. Laboratory analysis of the fungal mass found it to be Candida dubliniensis.

  17. A CASE OF HUGE GASTRIC DISOPYROBEZOAR

    Institute of Scientific and Technical Information of China (English)

    Zhong-liang Yang; Rui-li Zhang; Bo-guang Fan

    2007-01-01

    @@ PHYTOBEZOARS are common bezoars in gastrointestinal tract, commonly seen in stomach and small intestine, 1 but huge disopyrobezoars are rarely seen in clinic. We aimed to report a case of huge disopyrobezoar ( 18 cm × 7.5 cm × 7 cm), a kind of phytobezoar caused by persimmon, and to present our experience by reviewing literatures.

  18. Ventrikelbezoar forårsaget af bariumsulfat

    DEFF Research Database (Denmark)

    Nielsen, Marie Kristina Rue; Ewertsen, Caroline; Hillingsø, Jens Georg

    2012-01-01

    We present the first case of a gastric bezoar caused by barium sulphate acting as an intermittently occluding mass in a patient who had undergone small bowel follow-through on suspicion of small bowel obstruction (SBO) after total pancreatectomy. The patient underwent acute surgery but intermitte...

  19. Úlcera gástrica terebrante e pancreatite aguda provocadas por tricobezoar Gastric ulcer and acute pancreatitis caused by trichobezoar

    Directory of Open Access Journals (Sweden)

    Alvaro Queiroz de Godoy

    2004-02-01

    Full Text Available Bezoar is a foreing body whitin the digestive tract originated from ingestion of varied substances, mainly vegetal fiber or hair. We present a case of a 14-year-old girl with trichotillomania, gastric trichobezoar, gastric ulcer and acute pancreatitis. The patient was operated on for anterior gastrotomy and removal of trichobezoar, with good postoperative follow-up. We illustrate this case to emphasize the need for recognition of gastric ulcer with acute pancreatitis and surgical management.

  20. Small bowel obstruction due to phytobezoar formation within meckel diverticulum: CT findings

    Energy Technology Data Exchange (ETDEWEB)

    Frazzini, V.I. Jr.; English, W.J.; Bashist, B.; Moore, E. [Columbia Univ. College of Physicians and Surgeons, New York, NY (United States)

    1996-05-01

    Intestinal obstruction due to a phytobezoar within a Meckel diverticulum is exceedingly rare, with only seven reported cases in the surgical literature. The most important precipitating factor is the ingestion of agents high in fiber and cellulose. Small bowel obstruction in all but one case was due to retrograde propagation of the bezoar into the small bowel lumen. We report the clinical and CT findings in such a patient following a vegetarian diet. 14 refs., 2 figs.

  1. Extração de fitobezoar gástrico por videolaparoscopia: considerações técnicas originais Videolaparoscopic extraction of gastric phytobezoar: original technical aspects

    OpenAIRE

    Carlos Eduardo Domene; Marcos Aun; Paula Volpe

    2002-01-01

    Videolaparoscopic surgery has been used for treatment of almost all surgical abdominal diseases, mainly where there are no large ressections, or operative field is limited. In these situations, laparoscopic surgery has the advantages of less morbidity, quick recovery and good cosmetic results. Bezoars removal, or its mobilization, is probably included in these possible proceedings. Three non-laparotomic procedures were described: 1. endoscopic-laparoscopic; 2. videolaparoscopy and mobilizatio...

  2. Esophageal space-occupying lesion caused by Ascaris lumbricoides

    OpenAIRE

    Zheng, Ping-Ping; Wang, Bing-Yuan; Wang, Fei; Ao, Ran; Wang, Ying(School of Physics, Shandong University, Jinan, 250100, PR China)

    2012-01-01

    Ascaris lumbricoides is the largest intestinal nematode parasite of man, which can lead to various complications because of its mobility. As the esophagus is not normal habitat of Ascaris, the report of esophageal ascariasis is rare. An old female presented with dysphagia after an intake of several red bean buns and haw jellies. The barium meal examination revealed a spherical defect in the lower esophagus. Esophageal bezoar or esophageal carcinoma was considered at the beginning. The patient...

  3. Uncommon Presentation of Gastric Trichobezoar: A Case Report

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    Sam ZERAATIAN

    2015-10-01

    Full Text Available Every material that gastrointestinal system cannot digest will make a bezoar. Trichobezoar is the result of hair inges-tion whether self-hair or from others and is not a common disorder in humans. It is a hairball, which mostly has been seen in females at teenage, or adolescence. It usually locates in stomach but in rare conditions, it will pass through the intestine, and make the Rapunzel syndrome. Herein we present a 13-year-old girl suffering from gastric trichobezoar presenting with failure to thrive.

  4. Perfuração gástrica por tricobezoar Gastric perforation secondary to trichobezoar

    Directory of Open Access Journals (Sweden)

    Elisanio de Souza Cardoso

    1998-12-01

    Full Text Available Bezoars are uncommon foreign bodies found in the stomach and intestines. They are usually secundary to "strange" or "weird" alimentary habits. The contents may include hait; stones, vegetal fibers and others. Diagnosis is generally made due to complications, mainly parcial or complete obstruction of the segment affected. Bleeding and peiforation may also occur: This paper describes a case of a 14-years-old female patient, who presented herself to lhe Emergency Room and was diagnosed as having a gastric peiforation due to a trichobezoar that was 15 cm long and weighted 900g. A review of lhe literature and comments about diagnosis and management are presented.

  5. Síndrome de Rapunzel: reporte de un caso

    Directory of Open Access Journals (Sweden)

    María Aguilar-Arauz

    2003-06-01

    Full Text Available Se reporta el caso de una niña de tres años con pérdida de peso, anemia ferropénica y síntomas digestivos de varios meses de evolución, quien presentó un episodio de dolor y distensión abdominal intenso, que requirió manejo quirúrgico. Se evidenció la presencia de un tricobezoar asociado con un síndrome de Rapunzel. El síndrome de Rapunzel consiste en la formación de una cola de pelo extendida desde estómago hacia intestino, lo que produce un efecto de acordeón en las asas intestinales, que lleva a necrosis isquémica. Los bezoares, son cuerpos extraños en el tracto gastrointestinal, que pueden ocurrir como resultado de la ingesta de objetos o comidas que no atraviesan el píloro, aumentan de tamaño al sumarse fibras y comida no absorbible. El término se origina a partir de badzher del árabe, padzhar del persa y beluzaar del hebreo, que significan antídoto , ya que en culturas antiguas las piedras o sustancias duras que se encontraban en los estómagos o intestinos de los animales se consideraban sagradas, y se decía tenían poderes curativos. Los bezoares se han observado en mujeres con problemas de personalidad o en individuos portadores de desequilibrios psiquiátricos. Usualmente se desarrollan como complicaciones de cirugía gástrica que alteran la función pilórica, o en circunstancias en que disminuyan la motilidad gástrica o disminuyen la acidez del estómago. Se dividen en varias categorías según el material constituyente: fitobezoares, tricobezoares, lactobezoares, bezoares de levaduras, bezoares como secuelas de cirugía gástrica, concreciones de materiales inorgánicos (asfalto, arena, goma, entre otros.

  6. Síndrome de Rapunzel: reporte de un caso

    Directory of Open Access Journals (Sweden)

    María Aguilar-Arauz

    2003-06-01

    Full Text Available Se reporta el caso de una niña de tres años con pérdida de peso, anemia ferropénica y síntomas digestivos de varios meses de evolución, quien presentó un episodio de dolor y distensión abdominal intenso, que requirió manejo quirúrgico. Se evidenció la presencia de un tricobezoar asociado con un síndrome de Rapunzel. El síndrome de Rapunzel consiste en la formación de una cola de pelo extendida desde estómago hacia intestino, lo que produce un efecto de acordeón en las asas intestinales, que lleva a necrosis isquémica. Los bezoares, son cuerpos extraños en el tracto gastrointestinal, que pueden ocurrir como resultado de la ingesta de objetos o comidas que no atraviesan el píloro, aumentan de tamaño al sumarse fibras y comida no absorbible. El término se origina a partir de badzher del árabe, padzhar del persa y beluzaar del hebreo, que significan antídoto , ya que en culturas antiguas las piedras o sustancias duras que se encontraban en los estómagos o intestinos de los animales se consideraban sagradas, y se decía tenían poderes curativos. Los bezoares se han observado en mujeres con problemas de personalidad o en individuos portadores de desequilibrios psiquiátricos. Usualmente se desarrollan como complicaciones de cirugía gástrica que alteran la función pilórica, o en circunstancias en que disminuyan la motilidad gástrica o disminuyen la acidez del estómago. Se dividen en varias categorías según el material constituyente: fitobezoares, tricobezoares, lactobezoares, bezoares de levaduras, bezoares como secuelas de cirugía gástrica, concreciones de materiales inorgánicos (asfalto, arena, goma, entre otros.We report the case of a 3-year-old female who for several months had unespecific digestive symptoms, weigth loss and iron deficiency anaemia. She suffered an acute abdominal pain episode associated with tenderness that required an exploratory laparotomy. A thrichobezoar was found in the stomach which was

  7. Treatment of gastric phytobezoars with Coca-Cola® given via oral route: a case report

    Directory of Open Access Journals (Sweden)

    Ertuğrul G

    2012-02-01

    Full Text Available Gökhan Ertuğrul1, Murat Coşkun1, Mahsuni Sevinç1, Fisun Ertuğrul2, Toygar Toydemir31Department of General Surgery, Düzce Atatürk State Hospital, Muncurlu, Düzce, Turkey; 2Department of Anaesthesiology and Reanimation, Düzce Atatürk State Hospital, Muncurlu, Düzce, Turkey; 3Department of General Surgery, İstanbul Surgery Hospital, Nisantasi, İstanbul, TurkeyBackground: A 43-year-old female patient presented with a chief complaint of upper abdominal pain. As her complaints had lasted for 1 month, an upper gastrointestinal system endoscopy was performed and discovered a bezoar in the stomach.Case presentation: The bezoar was quite hard and light green-yellow in color. Pathological examination revealed phytobezoar. The patient was hospitalized and given oral Coca-Cola® Zero for seven days at a dose of 500 mL three times daily.Conclusion: The upper gastrointestinal system endoscopy performed at the end of 7 days showed that the phytobezoar had softened and become smaller. The phytobezoar was broken into pieces with biopsy forceps and washing was applied, so the phytobezoar pieces could pass through the pylorus. The patient was discharged after the procedure without problem.Keywords: gastric phytobezoar, Coca-Cola, upper gastrointestinal system endoscopy

  8. Rapunzel Syndrome: Rare ‘Tale’ of a Broken ‘Tail’

    Science.gov (United States)

    Chauhan, Narvir S.; Kumar, Satish; Bhoil, Rohit

    2016-01-01

    Summary Background Rapunzel syndrome is a rare and unique form of trichobezoar, in which a cast of hairs is formed in the stomach with its ‘tail’ extending up to varying lengths into the small bowel. Almost all cases described in literature are of ‘classic’ and more common form of Rapunzel. Sometimes however, the tail of bezoar is broken into smaller fragments. There is not much literature available on this rarer subset of Rapunzel syndrome. Case Report In this report we present the ultrasound (USG) and CT findings of a case of Rapunzel syndrome in which the tail had broken into five separate fragments. The patient presented clinically with intestinal obstruction due to the impaction of the distal- most fragment in the ileum. Conclusions Our case highlights the fact that although USG features may be suggestive, a careful evaluation of CT images is essential for a confidant preoperative diagnosis of Rapunzel syndrome. In cases of this syndrome with a broken tail, CT is essential for precise count and localization of the separated fragments to ensure their complete removal at the time of surgery. We also propose to name the fragments of the broken tail as ‘bezoarlets’. This word aptly describes the tail fragments as it suggests their origin from the larger gastric bezoar and the suffix ‘lets’ conveys they are smaller in size.

  9. Tricobezoar gástrico: relato de caso e revisão da literatura

    Directory of Open Access Journals (Sweden)

    César Tadeu Spadella

    1998-04-01

    Full Text Available Bezoar é a impactação de material estranho no interior do trato digestivo, originado a partir da ingestão de diversas substâncias, incluindo cabelos ou pêlos, fibras vegetais e outros. No presente estudo relata-se caso de um volumoso tricobezoar gástrico observado em uma adolescente de 16 anos, com queixa de dor e tumoração palpável na região epigástrica, diagnosticado através da endoscopia digestiva alta. Dada às proporções do bezoar, a paciente foi submetida à gastrotomia anterior com retirada de uma massa sólida de cabelos, com 1200 g, a qual moldava todo o estômago, desde o fundo até o piloro. Uma grande úlcera de pressão também foi detectada em região antral, cujas biópsias revelaram- se negativas para neoplasia. Após a alta, sem intercorrências, a paciente foi encaminhada ao Serviço de Neuropsiquiatria para o tratamento da tricofagia e prevenção da recorrência, objetivo final, ao nosso ver, de todo o tratamento.Bezoar is an impaction of swallowed foreign material into the digestive tract. It is formed from several substances included hairs of humans or animals, vegetable matters and others. At present study the authors report a case of a voluminous gastric trichobezoar observed in a 16-yr-old adolescent with abdominal pain and palpated mass in the epigastrium. Trichobezoar was diagnosed throughout fiberoptic gastroscopy and laparotomy was indicated due to exaggerated size of the mass. Anterior gastrotomy was performed and a solid mass of hairs weighting 1200 g was removed. The removed mass occupied the whole stomach from fundus to pylorus. A big pression ulcer was also detected in the antrum. Biopsies of this ulcer showed to be negatives for neoplasy. There were no complications in postoperative recovery. After discharge the patient was referred to the Neuropsychiatric Service for treatment of trichophagia and prevention of recurrence, in our point of view, the main purpose of all treatment.

  10. Gastric Trichobezoar Causing Intermittent Small Bowel Obstruction: Report of a Case and Review of the Literature

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    Nicole G. Coufal

    2011-01-01

    Full Text Available We report the unusual case of a 45-year-old woman who presented with multiple episodes of small bowel obstruction. Initial exploratory lap-roscopy did not reveal an etiology of the obstruction. Subsequent upper endoscopy identified a non-obstructing gastric trichobezoar which could not be removed endoscopically but was not thought to be responsible for the small bowel obstruction given its location. One week postoperatively, the patient experienced recurrence of small bowel obstruction. Repeat endoscopy disclosed that the trichobezoar was no longer located in the stomach and upon repeat laparotomy was extracted from the mid-jejunum. In the following 8 months, the patient had no further episodes of small bowel obstruction. Consequently, gastric bezoars should be included in the differential diagnosis of recurrent small bowel obstruction.

  11. A Rare Cause of Abdominal Mass: Trichobezoar

    Directory of Open Access Journals (Sweden)

    Atakan Comba

    2013-04-01

    Full Text Available Bezoar is a mass that cannot be digested and that is collected in the gastrointestinal system. Being the exact frequency still unknown; it is rare among children. Trichobezoar is especially encountered in young adolescent girls who have psychiatric/neurologic problems. In this report; a fifteen year old girl who has stomachache and vomiting is presented. A mass without pain on palpation was diagnosed as trichobezoar by performing an endoscopy. A mass which weighed 1.5 kilograms and which took the shape of the stomach was removed out of her stomach by laparatomy. On her psychiatric examination; she was diagnosed with mild mental retardation and obsessive compulsive disorder. Trichobezoar should be considered when adolescent girls with psychiatric problems come with gastrointestinal symptoms such as stomachache and vomiting. (The Jo­ur­nal of Cur­rent Pe­di­at­rics 2014;1:51-3

  12. Nutritional therapy for the management of diabetic gastroparesis: clinical review

    Directory of Open Access Journals (Sweden)

    Sadiya A

    2012-09-01

    Full Text Available Amena SadiyaLifestyle Clinic, Rashid Centre for Diabetes and Research, Ministry of Health, Ajman, United Arab EmiratesAbstract: Diabetic gastroparesis (DGP, or slow emptying of the stomach, is a well-established complication of diabetes mellitus and is typically considered to occur in individuals with long-standing type 1 and type 2 diabetes mellitus. Clinical consequences of DGP include induction of gastrointestinal (GI symptoms (early satiety, abdominal distension, reflux, stomach spasm, postprandial nausea, vomiting, alteration in drug absorption, and destabilization of glycemic control (due to mismatched postprandial glycemic and insulin peaks. Effective nutritional management not only helps in alleviating the symptoms, but also in facilitating better glycemic control. Although there have been no evidence-based guidelines pertaining to the nutrition care process of the DGP, the current dietary recommendations are based on expert opinions or observational studies. The dietary management of gastroparesis needs to be tailored according to the severity of malnutrition and kind of upper GI symptom by changing the volume, consistency, frequency, fiber, fat, and carbohydrates in the meal. Small frequent meals, using more liquid calories, reducing high fat or high fiber, consuming bezoar forming foods, and adjusting meal carbohydrates based on medications or insulin helps in improving the upper GI symptoms and glycemic control. Enteral nutrition can be an option for patients who fail to stabilize their weight loss, or for those who cannot gain weight with oral feedings, while total parenteral nutrition is rarely necessary for the patient with gastroparesis.Keywords: diabetic gastroparesis, delayed gastric emptying, diabetes mellitus, bezoar, GI symptoms, glycemic control

  13. Presence-absence surveys of prey and their use in predicting leopard (Panthera pardus) densities: a case study from Armenia.

    Science.gov (United States)

    Khorozyan, Igor G; Malkhasyan, Alexander G; Abramov, Alexei V

    2008-12-01

    It is important to predict how many individuals of a predator species can survive in a given area on the basis of prey sufficiency and to compare predictive estimates with actual numbers to understand whether or not key threats are related to prey availability. Rugged terrain and low detection probabilities do not allow for the use of traditional prey count techniques in mountain areas. We used presence-absence occupancy modeling and camera-trapping to estimate the abundance and densities of prey species and regression analysis to predict leopard (Panthera pardus) densities from estimated prey biomass in the mountains of the Nuvadi area, Meghri Ridge, southern Armenia. The prey densities were 12.94 ± 2.18 individuals km(-2) for the bezoar goat (Capra aegagrus), 6.88 ± 1.56 for the wild boar (Sus scrofa) and 0.44 ± 0.20 for the roe deer (Capreolus capreolus). The detection probability of the prey was a strong function of the activity patterns, and was highest in diurnal bezoar goats (0.59 ± 0.09). Based on robust regression, the estimated total ungulate prey biomass (720.37 ± 142.72 kg km(-2) ) can support a leopard density of 7. 18 ± 3.06 individuals 100 km(-2) . The actual leopard density is only 0.34 individuals 100 km(-2) (i.e. one subadult male recorded over the 296.9 km(2) ), estimated from tracking and camera-trapping. The most plausible explanation for this discrepancy between predicted and actual leopard density is that poaching and disturbance caused by livestock breeding, plant gathering, deforestation and human-induced wild fires are affecting the leopard population in Armenia. PMID:21396082

  14. Imaging Diagnosis of Large Gastric Trichobezoar: A Case Report and Literature Review%超声诊断巨大毛发性胃结石一例及文献复习

    Institute of Scientific and Technical Information of China (English)

    刘莉; 穆靓; 秦民惠; 李莘; 韦爱华; 张阳

    2011-01-01

    Objective: To investigate the imaging manifestations, clinical features and treatment of large gastric trichobezoar. Methods: The clinical data, imaging findings and treatment of large gastric trichobezoar in one case was retrospectively analyzed with literature review. Results: The child, abdominal pain more than half a year, was diagnosed with large gastric trichobezoar by ultrasound scan. A throughout anamnesis revealed a trichotillomania with trichophagia. Surgery was in form of a laparotomy with gastrotomy through which the mass was evacuated after endoscopic technique confirmed. She was discharged with follow-up remained well. Conclusion: There are no significant differences about imaging manifestations and clinical features between large gastric trichobezoar and other gastric bezoars. The ultrasonic inspection may provide important findings. The aim of treatment is to remove the bezoar and prevent recurrence. It is also recommended that these patients should be evaluated and followed up in a psychiatric clinic.%目的:探讨毛发性胃结石的影像表现、临床特点及治疗.方法:回顾性分析1例毛发性胃结石患者的临床资料,结合文献报道,对其影像、临床表现和治疗方法进行探讨.结果:患者为一女性患儿,上腹痛不适半年余,既往有拔毛癖,超声诊断胃巨大毛发性结石,内镜证实后开腹手术,取石成功,随访痊愈.结论:毛发性胃结石与其它胃结石相比,影像表现、临床特点无明显差异,超声检查可提供可靠的诊断提示,治疗需取出结石以消除症状,并注意心理干预,防止复发.

  15. Retrospectiva de casos de corpos estranhos no tubo digestivo de gatos Retrospective study of foreign bodies cases at digestive tube in cats

    Directory of Open Access Journals (Sweden)

    Franklin de Almeida Sterman

    1997-12-01

    Full Text Available Neste trabalho são apresentados os resultados da revisão da casuística de 13 anos (1977-1989 sobre presença de corpos estranhos localizados no tubo digestivo de gatos atendidos pelo Serviço de Patologia e Clínica Cirúrgicas do Departamento de Cirurgia da Faculdade de Medicina Veterinária e Zootecnia da USP e triados pelo Hospital Veterinário da mesma entidade. Após exames clínico e radiográfico observou-se, em 12 felinos da raça Siamês e sem raça definida, machos e fêmeas com idade variando entre dois e 168 meses, corpos estranhos, localizados desde a orofaringe até intestino e de diferentes origens - ossos, agulhas, linha, plástico, borracha e bezoar - apresentando como principais sinais anorexia e vômitos. Nove gatos foram submetidos a intervenção cirúrgica para a resolução do processo e do total de animais com diagnóstico de corpo estranho no trato digestivo foi constatado um óbito. Conclui-se, pelo período avaliado, que os corpos estranhos no tubo digestivo de galos não são observados com frequência, apresentando prognóstico favorável de cura, e havendo tendência de aumento no número de casos.This study presents a 13 years casuistic review of oesophageal and gastrointestinal foreign bodies. The cases were admitted at the surgical pathology and clinics of the Surgery Department of the Faculdade de Medicina Veterinária e Zootecnia da Universidade de São Paulo. At clinical and radiographic examination, foreign bodies were detected in 12 cats, with age from 2 to 168 months, without prevalence of sex and affecting more cats with indefined breed. The found foreign bodies were located from oropharinx to intestines, among them: bones, needles, string, plastic, rubber and bezoar, presentingg as main clinical signs: anorexia and vomiting. Surgery was performed to solve the problem and among all the animals, onty one death ocurred. This review shows that foreign bodies are not common in cats and usually have good

  16. Benign gastric filling defect

    International Nuclear Information System (INIS)

    The gastric lesion is a common source of complaints to Orientals, however, evaluation of gastric symptoms and laboratory examination offer little specific aid in the diagnosis of gastric diseases. Thus roentgenography of gastrointestinal tract is one of the most reliable method for detail diagnosis. On double contract study of stomach, gastric filling defect is mostly caused by malignant gastric cancer, however, other benign lesions can cause similar pictures which can be successfully treated by surgery. 66 cases of benign causes of gastric filling defect were analyzed at this point of view, which was verified pathologically by endoscope or surgery during recent 7 years in Yensei University College of Medicine, Severance Hospital. The characteristic radiological picture of each disease was discussed for precise radiologic diagnosis. 1. Of total 66 cases, there were 52 cases of benign gastric tumor 10 cases of gastric varices, 5 cases of gastric bezoar, 5 cases of corrosive gastritis, 3 cases of granulomatous disease and one case of gastric hematoma. 2. The most frequent causes of benign tumors were adenomatous polyp (35/42) and the next was leiomyoma (4/42). Others were one of case of carcinoid, neurofibroma and cyst. 3. Characteristic of benign adenomatous polyp were relatively small in size, smooth surface and were observed that large size, benign polyp was frequently type IV lesion with a stalk. 4. Submucosal tumors such as leiomyoma needed differential diagnosis with polypoid malignant cancer. However, the characteristic points of differentiation was well circumscribed smooth margined filling defect without definite mucosal destruction on surface. 5. Gastric varices showed multiple lobulated filling defected especially on gastric fundus that changed its size and shape by respiration and posture of patients. Same varices lesions on esophagus and history of liver disease were helpful for easier diagnosis. 6. Gastric bezoar showed well defined movable mass

  17. A Literary Study on Moschus

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    Kyu Jae Lee

    2005-12-01

    Full Text Available Objective : Literary investigation of existing data was conducted to verify effects of Moschus and its herbal acupuncture, and determine quality management through component analysis. Results : Following results were obtained through literary investigation. 1. Deer musk (Moschus is dried navel gland secretions of the adult male musk deer. 2. Moschus is known to be effective for treating various febrile diseases, to revive senses, heart and abdominal pain, complications from cerebral hemorrhage, angina, and others. 3. Single dosage of Moschus is between and should not exceed 1g. Normally taken as powder or pill and may be used externally. 4. Moschus also has protective effects for the liver cells, and experiments revealed possible efficacies for hyperlipidemia, brain damage, hypertension, and etc. 5. For herbal acupuncture usage, Fel Ursi, Bezoar Bovis, and Moschus are used as a mixture (BUM, and it's known to be effective for protecting the liver and treating arthritis. 6. For component analysis of Moschus, aromatic matter 'muscone' should be used as a standard matter.

  18. Gastric necrosis: A late complication of nissen fundoplication.

    Science.gov (United States)

    Salinas, Javier; Georgiev, Tihomir; González-Sánchez, Juan Antonio; López-Ruiz, Elena; Rodríguez-Montes, José Antonio

    2014-09-27

    Gastric necrosis is a rare condition because of the rich blood supply and the extensive submucosal vascular network of the stomach. "Gas-bloat" syndrome is a well known Nissen fundoplication postoperative complication. It may cause severe gastric dilatation, but very rarely an ischemic compromise of the organ. Other factors, such as gastric outlet obstruction, may concur to cause an intraluminal pressure enough to blockade venous return and ultimately arterial blood supply and oxygen deliver, leading to ischaemia. We report a case of a 63-year-old women, who presented a total gastric necrosis following laparoscopic Nissen fundoplication and a pyloric phytobezoar which was the trigger event. No preexisting gastric motility disorders were present by the time of surgery, as demonstrated in the preoperative barium swallow, thus a poor mastication (patient needed no dentures) of a high fiber meal (cabbage) may have been predisposing factors for the development of a bezoar in an otherwise healthy women at the onset of old age. A total gastrectomy with esophagojejunostomy was performed and patient was discharged home after a 7-d hospital stay with no immediate complications. We also discuss some technical aspects of the procedure that might be important to reduce the incidence of this complication. PMID:25276288

  19. Trichophagia along with trichobezoar in the absence of trichotillomania

    Directory of Open Access Journals (Sweden)

    Aseem Mehra

    2014-01-01

    Full Text Available Trichobezoars are rarely described in the absence of trichotillomania. In this report we present a case of trichobezoar associated with trichophagia in the absence of trichotillomania. A 16-year-old girl presented to surgery outpatient with complaints of pain in abdomen and vomiting for the last 6 months. Physical examination revealed a 14 × 16 cm firm, tender, mass with smooth surface, irregular margins, which was mobile with respiration. Ultrasound abdomen revealed a bizarre lesion in the right upper and middle abdomen suggestive of gastric bezoars. Upper gastrointestinal endoscopy did not reveal any abnormality in the esophagus and showed a large mobile mass in the stomach. In view of trichobezoar, psychiatry consultation was sought. Exploration of history revealed that the patient was eating hairs and clay since early childhood. As per patient she would eat hairs thrown by others. She would like the taste of hair and had strong persistent desire to eat hair and would go out searching for the same. At times she would also eat clay. However, she denied of pulling her own hairs. Physical examination of scalp and other body parts did not show any evidence of alopecia or pulling of hair/short hair. She was managed surgically and was counseled about the consequences of eating hairs and clays and was encouraged not to eat hair. To conclude our case suggests that patients can have trichobezoar and trichophagia even in the absence of trichotillomania.

  20. Esophageal space-occupying lesion caused by Ascaris lumbricoides

    Institute of Scientific and Technical Information of China (English)

    Ping-Ping Zheng; Bing-Yuan Wang; Fei Wang; Ran Ao; Ying Wang

    2012-01-01

    Ascaris lumbricoides is the largest intestinal nematode parasite of man,which can lead to various complications because of its mobility.As the esophagus is not normal habitat of Ascaris,the report of esophageal ascariasis is rare.An old female presented with dysphagia after an intake of several red bean buns and haw jellies.The barium meal examination revealed a spherical defect in the lower esophagus.Esophageal bezoar or esophageal carcinoma was considered at the beginning.The patient fasted,and received fluid replacement treatment as well as some oral drugs such as proton pump inhibitor and sodium bicarbonate.Then upper gastrointestinal endoscopy was done to further confirm the diagnosis and found a live Ascaris lumbricoides in the gastric antrum and two in the duodenal bulb.The conclusive diagnosis was ascariasis.The esophageal space-occupying lesion might be the entangled worm bolus.Anthelmitnic treatment with mebendazole improved patient's clinical manifestations along with normalization of the radiological findings during a 2-wk follow-up.Authors report herein this rare case of Ascaris lumbricoides in the esophagus,emphasizing the importance of awareness of this parasitic infection as it often presents with different and unspecific symptoms.

  1. Assessing the Role of Livestock in Big Cat Prey Choice Using Spatiotemporal Availability Patterns.

    Science.gov (United States)

    Ghoddousi, Arash; Soofi, Mahmood; Kh Hamidi, Amirhossein; Lumetsberger, Tanja; Egli, Lukas; Khorozyan, Igor; Kiabi, Bahram H; Waltert, Matthias

    2016-01-01

    Livestock is represented in big cat diets throughout the world. Husbandry approaches aim to reduce depredation, which may influence patterns of prey choice, but whether felids have a preference for livestock or not often remains unclear as most studies ignore livestock availability. We assessed prey choice of the endangered Persian leopard (Panthera pardus saxicolor) in Golestan National Park, Iran, where conflict over livestock depredation occurs. We analyzed leopard diet (77 scats) and assessed wild and domestic prey abundance by line transect sampling (186 km), camera-trapping (2777 camera days), double-observer point-counts (64 scans) and questionnaire surveys (136 respondents). Based on interviews with 18 shepherds, we estimated monthly grazing time outside six villages with 96 conflict cases to obtain a small livestock (domestic sheep and goat) availability coefficient. Using this coefficient, which ranged between 0.40 and 0.63 for different villages, we estimated the numbers of sheep and goats available to leopard depredation. Leopard diet consisted mainly of wild boar (Sus scrofa) (50.2% biomass consumed), but bezoar goat (Capra aegagrus) was the most preferred prey species (Ij = 0.73), whereas sheep and goats were avoided (Ij = -0.54). When absolute sheep and goat numbers (~11250) were used instead of the corrected ones (~6392), avoidance of small livestock appeared to be even stronger (Ij = -0.71). We suggest that future assessments of livestock choice by felids should incorporate such case-specific corrections for spatiotemporal patterns of availability, which may vary with husbandry methods. Such an approach increases our understanding of human-felid conflict dynamics and the role of livestock in felid diets. PMID:27064680

  2. An 8-year review of barium studies in the diagnosis of gastroparesis

    International Nuclear Information System (INIS)

    Aim: To determine the utility of barium studies for diagnosing gastroparesis in patients with nausea, vomiting, or other related symptoms. Materials and methods: Radiology files revealed gastroparesis without gastric outlet obstruction on upper gastrointestinal tract barium studies in 50 patients with nausea, vomiting, and other related symptoms. Original reports and images were reviewed to determine whether gastric peristalsis was decreased/absent and to investigate gastric dilatation, fluid or debris, and delayed emptying of barium. Twenty patients (40%) had nuclear gastric emptying studies. Medical records were reviewed to determine the presentation, treatment, and course. The diagnosis of gastroparesis was considered accurate if patients with gastroparesis on barium studies responded to treatment. Results: Forty-six patients (92%) had predisposing factors for gastroparesis, including narcotics and diabetes. Forty-five patients (90%) presented with nausea or vomiting, and 40 patients (80%) had one or more other symptoms, including bloating, early satiety, postprandial fullness, and abdominal pain. Barium studies revealed decreased gastric peristalsis in 46 (92%) of the 50 patients and absent peristalsis in four (8%); 46 patients (92%) had additional findings, including gastric dilatation in 30 (60%), delayed emptying of barium in 27 (54%), debris in 28 (56%; bezoars in three), and retained fluid in 13 (26%). Thirteen (65%) of 20 patients with nuclear gastric emptying studies had delayed emptying of solids and seven (35%) had normal emptying. Thirty-five (83%) of 42 patients treated for gastroparesis had symptomatic improvement versus two (25%) of eight patients not treated. Conclusion: Patients with nausea, vomiting, or other related symptoms who have gastroparesis without gastric outlet obstruction on barium studies can be treated for this condition on the basis of the clinical and radiographic findings

  3. Primary renal candidiasis: fungal mycetomas in the kidney

    International Nuclear Information System (INIS)

    Fungal infections of the urinary tract have a predilection for drainage structures rather than for the renal parenchyma. Of the causal factors, diabetes mellitus, immunosuppressed states, AIDS and prematurity are those most commonly encountered. The case of a young, diabetic man whose chief clinical presentation was dysuria is described. On further examination he was found to harbour fungal balls in the right kidney. Radiological manifestations of acute pyelonephritis were also present. Although primary renal candidiasis is often commensurate with systemic fungaemia, he displayed none of the clinical features of disseminate infection and, hence, was treated conservatively with oral antifungal agents. Fortuitously, spontaneous passage of fungal particulate matter in urine was later reported. A significant increase in the incidence of fungal cystitis has been found in recent years; however, the patient presents with many non-specific features of cystitis. Both sonography and CT show thickening of the bladder wall but, again, this lacks specificity. In the rare instance of prostate involvement, low attenuation foci on CT are seen within the gland. Despite the existence of a large number of fungal species, only a few are pathogenic to humans. Of those that cause disease in the urinary tract, Candida albicans is the most frequently encountered. A highly characteristic finding in such infections is of fungal balls, which are made up of aggregates of mycelia. However, care should be exercised in interpretation as a host of other conditions can mimic fungal bezoars. Although a CT scan at initial examination may qualify as the more descriptive, sonography provides a serial non-invasive means of evaluating the urinary tract. When in doubt, a urine culture clinches the diagnosis. Copyright (2002) Blackwell Science Pty Ltd

  4. Efficacy of enteroclysis through Miller-Abbott tube for decompression in patients with postoperative intestinal obstruction

    International Nuclear Information System (INIS)

    The purpose of this study is to assess the efficacy of enteroclysis through the previously inserted Miller-Abbott (M-A) tube for decompression in the postoperative intestinal obstruction. This study includes twenty patients who has intestinal obstruction symptoms after operation for benign(12) or malignant(8) abdominal lesions. Small amount of barium was introduced to M-A tube for enteroclysis. We evaluated the presence, level, degree, and causes of obstruction on enteroclysis, compared with surgical(11) and clinical(9) findings. Obstruction was seen in 18 cases including the two cases in which the level of obstruction was not clear. There was no obstruction in two cases. Obstruction on enteroclysis was demonstrated in all 11 operated cases(100% accuracy, 11/11). The level of obstruction on enteroclysis were jejunum in three cases, ileum in seven, and colon in one case. The levels of obstruction on enteroclysis were matched with those in operation field in 10 cases. There were two cases of nonobstruction on enteroclysis were jejunum in three cases, ileum in seven, and colon in one case. The levels of obstruction on enteroclysis were matched with those in operation field in 10 cases. There were two cases of nonobstruction, nine cases of low-grade partial obstruction, and nine cases of high-grade partial obstruction. We analyzed the findings on enteroclysis regarding causes of obstruction in 16 patients with the findings of adhesive bands of extrinsic cause(9), cancer recurrence of intrinsic cause(6), and bezoar of intraluminal cause(1). Misinterpreted cases were two cases(87.7% accuracy, 14/16). The cause, for nonvisualization of obstruction site on enteroclysis in four patients included technical failure such as inadequate location of tube(1) and bowel overlapping(1), minimal obstruction(1), and nonexistent obstruction(1), in spite of diffuse edematous mucosa. Enteroclysis through the M-A tube for decompression in patients with postoperative intestinal obstruction

  5. Assessing the Role of Livestock in Big Cat Prey Choice Using Spatiotemporal Availability Patterns

    Science.gov (United States)

    Ghoddousi, Arash; Soofi, Mahmood; Kh. Hamidi, Amirhossein; Lumetsberger, Tanja; Egli, Lukas; Khorozyan, Igor; Kiabi, Bahram H.; Waltert, Matthias

    2016-01-01

    Livestock is represented in big cat diets throughout the world. Husbandry approaches aim to reduce depredation, which may influence patterns of prey choice, but whether felids have a preference for livestock or not often remains unclear as most studies ignore livestock availability. We assessed prey choice of the endangered Persian leopard (Panthera pardus saxicolor) in Golestan National Park, Iran, where conflict over livestock depredation occurs. We analyzed leopard diet (77 scats) and assessed wild and domestic prey abundance by line transect sampling (186 km), camera-trapping (2777 camera days), double-observer point-counts (64 scans) and questionnaire surveys (136 respondents). Based on interviews with 18 shepherds, we estimated monthly grazing time outside six villages with 96 conflict cases to obtain a small livestock (domestic sheep and goat) availability coefficient. Using this coefficient, which ranged between 0.40 and 0.63 for different villages, we estimated the numbers of sheep and goats available to leopard depredation. Leopard diet consisted mainly of wild boar (Sus scrofa) (50.2% biomass consumed), but bezoar goat (Capra aegagrus) was the most preferred prey species (Ij = 0.73), whereas sheep and goats were avoided (Ij = -0.54). When absolute sheep and goat numbers (~11250) were used instead of the corrected ones (~6392), avoidance of small livestock appeared to be even stronger (Ij = -0.71). We suggest that future assessments of livestock choice by felids should incorporate such case-specific corrections for spatiotemporal patterns of availability, which may vary with husbandry methods. Such an approach increases our understanding of human-felid conflict dynamics and the role of livestock in felid diets. PMID:27064680

  6. The surgical treatment of chronic gastric atony following Roux-Y diversion for alkaline reflux gastritis

    International Nuclear Information System (INIS)

    Symptoms of severe nausea, vomiting, abdominal pain, and frequent bezoars, as well as objective gastric retention, can occur following Roux-Y biliary diversion for alkaline reflux gastritis. Medical therapy and prokinetic drugs have proven ineffective. This review evaluates 37 patients who underwent further gastric resection from 1979 to 1987 to improve gastric emptying and resolve symptoms. Fifteen patients underwent perioperative radionuclide solid-food gastric emptying studies. Seventy-three per cent (27 of 37 patients) of the patients who underwent further gastric resection (70% to 95%) had a satisfactory postoperative response. Twenty patients were graded Visick 1 or 2 and 7 Visick-3 patients, although much improved, still had some symptoms of gastroparesis. Twenty-seven per cent (10 of 37 patients) failed to improve and underwent completion total gastrectomy. Overall, 70% of this group had almost complete resolution of their symptoms. Three of 10 patients were considered ''failures'' due to postprandial pain in 1 and early vasomotor dumping in 2. Of the 10 patients who failed initial revisional surgery, 7 underwent a 70% to 80% subtotal gastric resection (STG) and 3 patients underwent 85% to 95% extensive resection (EXT.G.). Of the 15 patients who underwent perioperative radionuclide evaluation, a mean two-hour gastric retention of 61.4% +/- 4% (SEM) decreased to 25% +/- 4% following further gastric resection. Eight patients were in the STG group and seven patients were in the EXT.G group. Following STG, mean two-hour gastric retention of 58.2% +/- 3.5% decreased to 38% +/- 3% (p less than 0.05). In seven patients who underwent EXT.G, mean two-hour retention of 65% +/- 4% decreased to 10% +/- 2.5% (p less than 0.005). EXT.G resulted in normal gastric emptying and few late failures

  7. An 8-year review of barium studies in the diagnosis of gastroparesis

    Energy Technology Data Exchange (ETDEWEB)

    Levin, A.A. [Department of Radiology, Hospital of University of Pennsylvania, Philadelphia, PA (United States); Levine, M.S. [Department of Radiology, Hospital of University of Pennsylvania, Philadelphia, PA (United States)], E-mail: marc.levine@uphs.upenn.edu; Rubesin, S.E.; Laufer, I. [Department of Radiology, Hospital of University of Pennsylvania, Philadelphia, PA (United States)

    2008-04-15

    Aim: To determine the utility of barium studies for diagnosing gastroparesis in patients with nausea, vomiting, or other related symptoms. Materials and methods: Radiology files revealed gastroparesis without gastric outlet obstruction on upper gastrointestinal tract barium studies in 50 patients with nausea, vomiting, and other related symptoms. Original reports and images were reviewed to determine whether gastric peristalsis was decreased/absent and to investigate gastric dilatation, fluid or debris, and delayed emptying of barium. Twenty patients (40%) had nuclear gastric emptying studies. Medical records were reviewed to determine the presentation, treatment, and course. The diagnosis of gastroparesis was considered accurate if patients with gastroparesis on barium studies responded to treatment. Results: Forty-six patients (92%) had predisposing factors for gastroparesis, including narcotics and diabetes. Forty-five patients (90%) presented with nausea or vomiting, and 40 patients (80%) had one or more other symptoms, including bloating, early satiety, postprandial fullness, and abdominal pain. Barium studies revealed decreased gastric peristalsis in 46 (92%) of the 50 patients and absent peristalsis in four (8%); 46 patients (92%) had additional findings, including gastric dilatation in 30 (60%), delayed emptying of barium in 27 (54%), debris in 28 (56%; bezoars in three), and retained fluid in 13 (26%). Thirteen (65%) of 20 patients with nuclear gastric emptying studies had delayed emptying of solids and seven (35%) had normal emptying. Thirty-five (83%) of 42 patients treated for gastroparesis had symptomatic improvement versus two (25%) of eight patients not treated. Conclusion: Patients with nausea, vomiting, or other related symptoms who have gastroparesis without gastric outlet obstruction on barium studies can be treated for this condition on the basis of the clinical and radiographic findings.

  8. Gastroparesis: approach, diagnostic evaluation, and management.

    Science.gov (United States)

    Tang, Derek M; Friedenberg, Frank K

    2011-02-01

    Gastroparesis is a chronic motility disorder of the stomach that involves delayed emptying of solids and liquids, without evidence of mechanical obstruction. Although no cause can be determined for the majority of cases, the disease often develops as a complication of abdominal surgeries or because of other underlying disorders, such as diabetes mellitus or scleroderma. The pathophysiology behind delayed gastric emptying is still not well-understood, but encompasses abnormalities at 3 levels--autonomic nervous system, smooth muscle cells, and enteric neurons. Patients will often cite nausea, vomiting, postprandial fullness, and early satiety as their most bothersome symptoms on history and physical examination. Those that present with severe disease may already have developed complications, such as the formation of bezoars or masses of undigested food. In patients suspected of gastroparesis, diagnostic evaluation requires an initial upper endoscopy to rule out mechanical causes, followed by a gastric-emptying scintigraphy for diagnosis. Other diagnostic alternatives would be wireless capsule motility, antroduodenal manometry, and breath testing. Once gastroparesis is diagnosed, dietary modifications, such as the recommendation of more frequent and more liquid-based meals, are encouraged. Promotility medications like erythromycin and antiemetics like prochlorperazine are offered for symptomatic relief. These agents may be frequently changed, as the right combination of effective medications will vary with each individual. In patients who are refractory to pharmacologic treatment, more invasive options, such as intrapyloric botulinum toxin injections, placement of a jejunostomy tube, or implantation of a gastric stimulator, are considered. Future areas of research are based on current findings from clinical studies. New medications, such as hemin therapy, are emerging because of a better understanding of the pathophysiology behind gastroparesis, and present treatment

  9. Tósigos y antídotos en la literatura cervantina: Sobre los venenos en la España tardorrenacentista

    Directory of Open Access Journals (Sweden)

    F López-Muñoz

    2011-01-01

    Full Text Available Los textos cervantinos constituyen una interesante fuente para el estudio de la sociedad española tardorrenacentista. Nosotros hemos abordado las obras de Cervantes desde la óptica de la toxicología, analizando el uso de agentes tóxicos y venenosos, fundamentalmente alucinógenos y narcóticos en el ámbito de la práctica de la brujería y hechicería (ungüentos de brujas, filtros de amor, pócimas venenosas, etc., así como las menciones a las hipotéticas sustancias dotadas de acción alexifármaca, como la verbena (Verbena officinalis, el cuerno de unicornio, las piedras bezoares o el castóreo. Las obras cervantinas en las que se hace referencia a estos preparados son las novelas El Quijote, La Galatea, Viaje del Parnaso y cuatro Novelas Ejemplares (La española inglesa, El licenciado Vidriera, El celoso extremeño y El coloquio de los perros, así como en las comedias Pedro de Urdemalas, La entretenida y El laberinto del amor. Entre los agentes tóxicos de origen herbal citados expresamente por Cervantes en el contexto analizado se encuentran el beleño (Hyoscyamus niger / albus, el tabaco (Nicotiana tabacum, la adelfa (Nerium oleander, el tártago (Euphorbia lathyris, el ruibarbo (Rheum officinale, Rumex alpinus y, de forma enmascarada, el opio (Papaver somniferum. En relación con el resto de preparados dotados de actividad tóxica, Cervantes no identifica sus ingredientes, aunque, a tenor de la sintomatología descrita por el autor, podrían ser plantas de la familia de las solanáceas, como el beleño, el solano, la datura, la belladona o la mandrágora. Con respecto a los tóxicos minerales, únicamente hay referencias a los efectos del mercurio o azogue. El Dioscórides comentado por Andrés Laguna pudo ser la fuente técnica utilizada por Cervantes para documentarse en esta materia.

  10. Evaluation of the usefulness of computed tomography on diagnosis and management of acute abdomen

    International Nuclear Information System (INIS)

    We evaluated the usefulness of computed tomography (CT) in diagnosing and managing acute abdomen. Subjects were 91 patients admitted complaining of acute abdominal pain and divided into two groups-those undergoing CT within 24 hours of admission (emergency CT group, n=70), those without CT (Non-CT group, n=21). The emergency CT group was subdivided into those with bowel obstruction (bowel obstruction group, n=29), those with acute appendicitis and other diseases necessitating differential diagnosis (appendicitis group, n=36), those with perforation of the digestive tract (perforation group, n=4), and other disease (n=1). We evaluated the accuracy of admission diagnosis retrospectively in each group. The final diagnosis of the bowel obstruction group was adhesive bowel obstruction in 16, colon cancer in 5, external hernia in 3 and other in 5. That in the appendicitis group was acute appendicitis in 25, colonic diverticulitis in 3, pelvic inflammatory disease in 3, ovarian hemorrhage in 2 and other in 5. The origin of perforation in the perforation group was upper digestive tract in 2 and lower digestive tract in 2. The sensitivity, specificity and accuracy of admission diagnosis in the emergency CT group was 91.1, 100 and 91.4%, respectively. The accuracy of admission diagnosis was 96.5% in the bowel obstruction group, 88.9% in the appendicitis group and 75.9% in the perforation group. Patients who could not be diagnosed precisely consisted of 6 patients in the emergency CT group. Those who could not be diagnosed precisely included 3 with pericecal abscess, 1 with acute appendicitis, 1 with stercoral perforation of the sigmoid colon and 1 with impacted bezoar in the small intestine. Evaluated retrospectively, 4 patients were able to be diagnosed by CT on admission. In diagnosis of acute abdomen, CT was useful in differential diagnosis of bowel obstruction and acute appendicitis, detection of fine free air, and determine of perforated sites. Emergency CT was thus

  11. A Study on the local thermal changes following herbal acupuncture on D.I.T.I.

    Directory of Open Access Journals (Sweden)

    Tae-han Yook

    2001-02-01

    Full Text Available Objectives : This study was done to observe the effect on the local thermal changes of herbal acupuncture on D.I.T.I.. The objects of this study are as follows; If there are remarkable local thermal changes between pre and post herbal acupuncture therapy on D.I.T.I.or not. If there are those, We examine how long that changes are maintained, what the adequate interval is on herbal acupuncture therapy, and what the reaction in a local or whole body are on that therapy. Materials and Methods : To study the local thermal changes in herbal acupuncture therapy, D.I.T.I. was used. Determination of this analysis periods are pre and post-therapy(1 hour, 24hours, 48hours and 7days later. The study group was divided into three groups(comprised 23 students in oriental medical college, Woosuk University. One was NS(Normal Saline group, another was CF(CARTHAMI SEMEN group and the other was BU(FEL URSI + BEZOAR BOVIS group. The Herbal Acupunture solution was injected 0.2ml divide into 0.05ml at the P'ungmun(B12, P'yesu(B13, Pubun(B41, Paek'o(B42 4 points. Then, in order to analyze the clinical form, we have observed response of 23 students whenever we checked the thermal changes of their after perfoming Results : The results were obtained as follows 1. There is no significant dermatothermal changes at NS group and CF group, but BU group have remarkable changes in 24, 48, 72 hours. 2. From post-therapy 1 hour to 48 hours, there is a significant change(p<0.01 at NS-BU group and CF-BU group, But there is none 7 days later. 3. In the analysis of whole or local body reaction, local pain appears at NS group(22%, CF group(11%, BU group(91%, discomfort reaction appears at CF group(14%, BU group(30%. BU group has feel vertigo(13%, drowsy(70% and pain in action(52%. 4. In the analysis of the duration of physical reaction, BU group is most lately maintained. Conclusions : These results suggest that in the physical reaction of herbal acupuncture solutions, BU solution is

  12. Prevention and Nursing Care of Elderly Patients With Postoperative Ileus Complicated With Infection%老年肠梗阻患者术后并发感染的预防和护理

    Institute of Scientific and Technical Information of China (English)

    李金红

    2015-01-01

    目的 探讨老年肠梗阻患者术后并发感染的预防及护理措施.方法 选取我院2012年1月~2014年6月老年肠梗阻患者40例,40例患者中25例伴有其他疾病,患慢支者10例,肺源性心脏病者4例,冠心病12例,高血压9例,糖尿病5例,并存两种以上疾病者5例.围术期给予心理护理、观察病情、切口护理、造瘘口护理及并发症护理等干预措施.结果 所有患者行手术治疗,术中发现肿瘤24例(60%),其中结肠癌18例(45%),直肠癌6例(15%),肠粘连8例(20%),粪石梗阻5例(12.5%)肠扭转1例(2.5%),嵌顿疝2例(5%).术后切口甲级愈合38例,乙级愈合2例,未发生泌尿系统、呼吸系统、口腔等感染,所有患者均康复出院.结论 对老年肠梗阻患者实施感染的预防护理效果显著,可减少术后感染的发生率.%Objective To investigate the prevention and nursing measures of concurrent infection of elderly patients with intestinal obstruction after operation. Methods Selected 40 cases of elderly patients with intestinal obstruction from 2012 January to 2014 June in our hospital.Among them, 25 casess with other diseases, 10 cases of patients suffering from chronic bronchitis, 4 cases of cor pulmonale, 12 cases of coronary heart disease (CHD), 9 cases of hypertension, 5 cases of diabetes, and 5 cases with two or more diseases. Adopted perioperative psychological nursing, observation of disease, care of the incision, stoma nursing and complications nursing intervention measures such as.Results Al patients with surgical treatment, 24 cases were found tumor during the operation (60%), including 18 cases (45%) of colon cancer and 6 cases (15%) of rectal cancer, 8 cases of intestinal adhesion (20%), 5 cases of bezoar obstruction (12.5%), 1 cases of volvulus (2.5%) and 2 cases of incarcerated hernia (5%). 38 cases of incision healing after operation, B healing in 2 cases, without the occurrence of urinary system, respiratory system, such as oral cavity

  13. 小儿咳嗽的中医临床治疗效果观察%Clinical treatment of children with cough in traditional Chinese Medicine

    Institute of Scientific and Technical Information of China (English)

    王锦

    2016-01-01

    Objective To study and analyze the TCM clinical treatment of infantile cough.Methods From March 2014 to Augst 2015 in our hospital for treatment of 84 cases of chronic cough were included in the study, according to the different treatment of the 84 patients were divided into TCM treatment group (n=42) and Western Medicine group (n=42). The Chinese medicine treatment group, using traditional Chinese medicine therapy, drug selection of infantile Feirekechuan oral liquid for the treatment of Western medicine group, with Ambroxol Hydrochloride Oral Solution, Bromhexine Hydrochloride Tablets, Compound Codeine Phosphate Solution, Compound Pholcodine Oral Solution, budesonide, salbutamol sulfate aerosol (Wan Tuolin), Pediatric Paracetamol Atificial Cow-bezoar and Chlorphenamine Maleate Granules. Pediatric Pseudoephedrine Hydrochloride and Dextromethorphan Hydrobromide Drops and other treatment, compared two groups of children with cough, expectoration, changes in breathing.Results TCM treatment group in cough, sputum, wheezing, improve the situation, better than western medicine treatment group, the above data were significant difference (P < 0.05), the difference is statistically significant.Conclusion The author thinks that, for children with cough, symptomatic treatment can obtain ideal curative effect, in this regard, Chinese medicine treatment method is superior to the traditional western medicine therapy and the treatment measures worthy of a wide range of promotion and use in clinical.%目的:研究并分析小儿咳嗽的中医临床治疗方式。方法:将2014年3月~2015年8月在我院接受治疗的84例慢性咳嗽患儿纳入到本研究,按照治疗方式的不同将84例患儿分为中医治疗组(n=42)与西医治疗组(n=42),对于中医治疗组,采用中药疗法,药物选择小儿肺热咳喘口服液,对于西医治疗组,采用盐酸氨溴索口服液、盐酸溴已新片、复方磷酸可待因溶液、复

  14. A study on the diagnostic accuracy of gastrofiberscopy in the diagnosis of various gastric diseases

    International Nuclear Information System (INIS)

    Gastrofiberscopy as well as roentgenologic examination of stomach, is now considered to be one of the indispensable diagnostic method of gastric disease. In general it is agreed that the roentgenologic examination is convenient for observation of shape, contour, motor function and gross lesion of stomach white gastrofiberscopy is especially valuable in detection of mucosal changes or small lesions of stomach. For evaluation of gastrofiberscopy in the diagnosis of various gastric diseases, the diagnostic accuracy of gastrofiberscopy was studied in 964 cases who underwent the fiberscopic examination in SNUH during the period from March 1, 1968 till April 30, 1971. The following results were obtained. 1. Each fiberscopic diagnosis in the 964 cases was classified as follows: normal stomach 414 cases (42.9%), gastritis 74 cases (7.7%), gastric ulcer 134 cases (13.9%), healed ulcer 14 cases (1.5%), benign pyloric stenosis 15 cases (1.6%), suspicious duodenal ulcer 23 cases (2.4%), gastric polyp 6 cases (0.6%), leiomyoma 1 case (0.1%), bezoar 2 cases (0.2%), xanthoma 1 case (0.1%), gastric carcinoma 237 case (24.6%), extrinstic mass 1 case (0.1%), post-operative condition 9 cases (0.9%), unsatisfactory examination 31 cases (3.2%), indeterminate diagnosis 2 cases (0.2%). 2. In various gastric diseases, the coincidence rate of diagnosis between fiberscopic and roentgenologic examination was studied and the obtained results are as follows: in normal stomach 72.9% (302/414), gastric ulcer 69.4% (93/134), healed ulcer 42.9% (6/14), benign pyloric stenosis 86.7% (13/15), duodenal ulcer 100.0% (23/23), gastric polyp 66.7% (4/6), gastric carcinoma 87.8% (208/237), post operative condition 66.7% (6/9). The overall result shows that the diagnostic coincidence between the two methods was observed in 67.7% of the cases (653/964). 3. The diagnostic accuracy of fiberscopic examination was 85.7% (24/28) in the diagnosis of gastric ulcer, 75.0% (6/8) in the diagnosis of benign pyloric