Clinical characteristics and treatment outcomes of nineteen Japanese patients with gastrointestinal bezoars

Masaya Iwamuro, Shouichi Tanaka, Junji Shiode, Atsushi Imagawa, Motowo Mizuno, Shigeatsu Fujiki, Tatsuya Toyokawa, Yuko Okamoto, Toshihiro Murata, Yoshinari Kawai, Daisuke Tanioka, Hiroyuki Okada, Kazuhide Yamamoto

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Objective: To analyze the clinical characteristics of patients with gastrointestinal bezoars and their response to therapy. Patients: We retrospectively reviewed the cases of 19 patients diagnosed with gastrointestinal bezoars at the Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences or one of 15 collaborating institutions between December 2004 and August 2013. We investigated the epidemiology and etiology of the gastrointestinal bezoars by determining the gender, age at diagnosis, medical history, symptoms, complications, modalities used for diagnosis, treatments, outcomes and bezoar location, color and contents. Results: There were 17 patients with gastric bezoars and two patients with small intestinal bezoars. All patients were 62 years of age or older, except for one case of a trichobezoar in a 10-year-old patient. Some of the patients had a history of surgery of any part of the gastrointestinal tract (n=5) and/or diabetes mellitus (n=2). The two patients with small intestinal bezoars required surgical removal in order to relieve ileus. Approximately one-half of the patients with gastric bezoars had ulcerations in the stomach (9/17 patients, 52.9%) and/or gastrointestinal bleeding (8/17, 47.1%). Endoscopic fragmentation was performed in 10 patients, whereas bezoar dissolution was achieved with a gastroprokinetic agent (n=1) and without any treatment (n=3) in the remaining cases. Conclusion: As previously reported, elderly individuals with a positive history of surgery and/or diabetes mellitus were observed in this bezoar patient series. Gastric ulcers and gastrointestinal bleeding were frequently observed. The majority of patients underwent endoscopic fragmentation, while spontaneous resolution of the gastric bezoar was observed in several cases.

Original languageEnglish
Pages (from-to)1099-1105
Number of pages7
JournalInternal Medicine
Volume53
Issue number11
DOIs
Publication statusPublished - 2014

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Bezoars
Stomach
Diabetes Mellitus
School Dentistry
Hemorrhage
Ileus
Stomach Ulcer

Keywords

  • Bezoar
  • Case series
  • Endoscopic removal
  • Foreign body

ASJC Scopus subject areas

  • Internal Medicine
  • Medicine(all)

Cite this

Clinical characteristics and treatment outcomes of nineteen Japanese patients with gastrointestinal bezoars. / Iwamuro, Masaya; Tanaka, Shouichi; Shiode, Junji; Imagawa, Atsushi; Mizuno, Motowo; Fujiki, Shigeatsu; Toyokawa, Tatsuya; Okamoto, Yuko; Murata, Toshihiro; Kawai, Yoshinari; Tanioka, Daisuke; Okada, Hiroyuki; Yamamoto, Kazuhide.

In: Internal Medicine, Vol. 53, No. 11, 2014, p. 1099-1105.

Research output: Contribution to journalArticle

Iwamuro, M, Tanaka, S, Shiode, J, Imagawa, A, Mizuno, M, Fujiki, S, Toyokawa, T, Okamoto, Y, Murata, T, Kawai, Y, Tanioka, D, Okada, H & Yamamoto, K 2014, 'Clinical characteristics and treatment outcomes of nineteen Japanese patients with gastrointestinal bezoars', Internal Medicine, vol. 53, no. 11, pp. 1099-1105. https://doi.org/10.2169/internalmedicine.53.2114
Iwamuro, Masaya ; Tanaka, Shouichi ; Shiode, Junji ; Imagawa, Atsushi ; Mizuno, Motowo ; Fujiki, Shigeatsu ; Toyokawa, Tatsuya ; Okamoto, Yuko ; Murata, Toshihiro ; Kawai, Yoshinari ; Tanioka, Daisuke ; Okada, Hiroyuki ; Yamamoto, Kazuhide. / Clinical characteristics and treatment outcomes of nineteen Japanese patients with gastrointestinal bezoars. In: Internal Medicine. 2014 ; Vol. 53, No. 11. pp. 1099-1105.
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abstract = "Objective: To analyze the clinical characteristics of patients with gastrointestinal bezoars and their response to therapy. Patients: We retrospectively reviewed the cases of 19 patients diagnosed with gastrointestinal bezoars at the Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences or one of 15 collaborating institutions between December 2004 and August 2013. We investigated the epidemiology and etiology of the gastrointestinal bezoars by determining the gender, age at diagnosis, medical history, symptoms, complications, modalities used for diagnosis, treatments, outcomes and bezoar location, color and contents. Results: There were 17 patients with gastric bezoars and two patients with small intestinal bezoars. All patients were 62 years of age or older, except for one case of a trichobezoar in a 10-year-old patient. Some of the patients had a history of surgery of any part of the gastrointestinal tract (n=5) and/or diabetes mellitus (n=2). The two patients with small intestinal bezoars required surgical removal in order to relieve ileus. Approximately one-half of the patients with gastric bezoars had ulcerations in the stomach (9/17 patients, 52.9{\%}) and/or gastrointestinal bleeding (8/17, 47.1{\%}). Endoscopic fragmentation was performed in 10 patients, whereas bezoar dissolution was achieved with a gastroprokinetic agent (n=1) and without any treatment (n=3) in the remaining cases. Conclusion: As previously reported, elderly individuals with a positive history of surgery and/or diabetes mellitus were observed in this bezoar patient series. Gastric ulcers and gastrointestinal bleeding were frequently observed. The majority of patients underwent endoscopic fragmentation, while spontaneous resolution of the gastric bezoar was observed in several cases.",
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