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      Colonic phytobezoar

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          Abstract

          ABSTRACT Bezoars, although rare, represent a small part of the etiologies of intestinal obstructions. They are indigestible masses formed in human beings consisting of hair, seeds, plant fibers, fruits, and even medications. The present report concerns a male patient with a complaint of interrupted flatus passage and feces elimination and pain in the left iliac fossa, initially suspected as a neoplasia of the sigmoid colon. However, analysis of the surgical specimen revealed that the condition was characterized by intestinal obstruction due to an encapsulated phytobezoar. This fact demonstrates the importance of a differential diagnosis, with emphasis on the relevance of considering the presence of bezoars despite their rare occurrence.

          Translated abstract

          RESUMO Os bezoares, embora raros, representam uma pequena parte das etiologias das obstruções intestinais. São massas indigestíveis formadas em seres humanos que consistem em cabelo, sementes, fibras vegetais, frutas e até mesmo medicamentos. O presente relato retrata um paciente do sexo masculino com uma queixa de parada de eliminação de flatos e fezes somado à dor na fossa ilíaca esquerda, que inicialmente suspeitou-se como neoplasia do cólon sigmoide. No entanto, a análise das peças cirúrgicas revelaram que a obstrução intestinal ocorreu devido à presença de um fitobezoar encapsulado. Este fato demonstra a importância do diagnóstico diferencial, com ênfase em considerar a presença de bezoares apesar de sua rara ocorrência.

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          Clinical Outcomes Associated with Treatment Modalities for Gastrointestinal Bezoars

          Background/Aims With technical and instrumental advances, the endoscopic removal of bezoars is now more common than conventional surgical removal. We investigated the clinical outcomes in a patient cohort with gastrointestinal bezoars removed using different treatment modalities. Methods Between June 1989 and March 2012, 93 patients with gastrointestinal bezoars underwent endoscopic or surgical procedures at the Asan Medical Center. These patients were divided into endoscopic (n=39) and surgical (n=54) treatment groups in accordance with the initial treatment modality. The clinical feature and outcomes of these two groups were analyzed retrospectively. Results The median follow-up period was 13 months (interquartile range [IQR], 0 to 77 months) in 93 patients with a median age of 60 years (IQR, 50 to 73 years). Among the initial symptoms, abdominal pain was the most common chief complaint (72.1%). The bezoars were commonly located in the stomach (82.1%) in the endoscopic treatment group and in the small bowel (66.7%) in the surgical treatment group. The success rates of endoscopic and surgical treatment were 89.7% and 98.1%, and the complication rates were 12.8% and 33.3%, respectively. Conclusions Endoscopic removal of a gastrointestinal bezoar is an effective treatment modality; however, surgical removal is needed in some cases.
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            A Case of Successful Colonoscopic Treatment of Colonic Obstruction Caused by Phytobezoar

            A phytobezoar is the most common type of bezoar, which is a gastrointestinal mass composed of vegetable. A persimmon is a common cause of a phytobezoar. The majority of bezoars are found in the stomach, with the small intestine being the next most commonly involved site. The colon is a rare site for a bezoar. Recently, we experienced a colonic bezoar that caused colonic obstruction in a 66-year-old female patient who took persimmons regularly. The patient came to the hospital because of abdominal pain and distension. To differentiate a tumor or other problems that can cause intestinal obstruction, we performed an abdominal computed tomography scan and found an ovoid intraluminal mass with a mottled gas pattern in the distal descending colon. A large impacted bezoar was seen in the sigmoid colon, which was completely obstructed, and it was successfully removed by using colonoscopy.
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              Memoire sur des cheveux trouver dans l'estomac et dans les intestins grêles

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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                jcol
                Journal of Coloproctology (Rio de Janeiro)
                J. Coloproctol. (Rio J.)
                Sociedade Brasileira de Coloproctologia (Rio de Janeiro, RJ, Brazil )
                2237-9363
                2317-6423
                September 2018
                : 38
                : 3
                : 246-249
                Affiliations
                [3] Curitiba Paraná orgnameUniversidade Federal do Paraná orgdiv1Hospital de Clínicas orgdiv2Departamento de Cirurgia Brazil
                [4] Curitiba Paraná orgnameUniversidade Federal do Paraná orgdiv1Hospital de Clínicas orgdiv2Serviço de Coloproctologia Brazil
                [1] Araraquara SP orgnameUniversidade de Araraquara orgdiv1Faculdade de Medicina de Araraquara Brazil
                [2] Matão SP orgnameHospital Carlos Fernando Malzoni orgdiv1Departamento de Cirurgia Brazil
                Article
                S2237-93632018000300246
                10.1016/j.jcol.2018.02.002
                2030c7ab-df89-4237-9f8c-020d63570bad

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

                History
                : 10 November 2017
                : 12 February 2018
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 9, Pages: 4
                Product

                SciELO Brazil


                Neoplasia de cólon,Intestinal obstruction,Colonic neoplasms,Bezoares,Obstrução intestinal,Bezoars

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