• anorexia
• diet
• endoscopy
• gastrolith
• stomach

• gastric ulcer
• gastrointestinal foreign body
• gastrolith
• ileus

• Case report
• Gastric outlet obstruction
• Pediatric surgery
• Pica
• Plastic bezoar

• Coca-Cola
• Gastric phytobezoar
• Iran

• Editorial
• Endoscopic treatment
• Oral dissolution treatment with Coca-Cola
• Phytobezoars
• Randomized study

• Bezoars
• Coca-Cola
• Gastroscopy
• Lithotripsy
• Solubility

• bezoars
• coca–cola
• diospyrobezoars
• efficacy
• gastric bezoars
• gastric lavage
• persimmon
• phytobezoar

• Acute peritonitis
• Gastric perforation
• Rapunzel syndrome
• Surgical intervention
• Trichobezoar
• Trichophagia

• bezoar
• cellulase
• coca-cola lavage
• phytobezoar

• ileus
• intestinal obstruction
• intussusception
• phytobezoar

• Bezoars
• Bleeding
• Capsule
• Crohn’s disease
• Foreign body
• Inflammatory bowel disease
• Retention
• Ulcerative colitis

Xylobezoar is a rare clinical condition in which undigested paper becomes trapped in the gastrointestinal tract causing varying degrees of gastrointestinal obstruction. This condition can be suspected in children with a history of gastric surgeries, decreased gastrointestinal motility, or pica. Xylobezoar presents with symptoms ranging from chronic abdominal pain to gastrointestinal perforation. Surgical intervention is often required as endoscopic removal is challenging and not always successful. Chemical dissolution has been shown to be effective in treating certain bezoars. Here, we report a case of a pediatric patient with xylobezoar who was successfully treated with continuous enteral Coca-Cola® infusion.

• bezoar
• depression
• digital impaction
• haematochezia
• occlusion
• pumpkin seeds

• Pediatric surgery
• rapunzel syndrome
• trichobezoar

• Adult
• Bezoars/diagnostic imaging
• Bezoars/surgery
• Endoscopy
• Gastric Outlet Obstruction/diagnostic imaging
• Gastric Outlet Obstruction/etiology
• Humans
• Male
• Stomach/diagnostic imaging

• Coca-Cola®
• endoscopic surgery
• gastric bezoars
• gastric outlet obstruction
• phytobezoars
• tannin

• Aged
• Bezoars/complications
• Bezoars/diagnostic imaging
• Bezoars/surgery
• Carbonated Beverages
• Coca
• Cola
• Gastric Outlet Obstruction
• Gastroscopy
• Humans
• Male
• Solubility
• Tannins

• POCUS
• Portal gas

• complication
• foreign body
• intestine
• risk factor
• surgery

Bezoars have different compositions and can be subdivided into trichobezoar, phytobezoar, pharmacobezoar, lactobezoar and food bolus. The reported incidence of bezoar is 0.4% with phytobezoar being the commonest. Rapunzel syndrome is an extremely rare complication when trichobezoar crosses the pylorus to enter the duodenum, ileum and colon. We present the case of a 29-year-old female with a one-week history of abdominal pain, anorexia, nausea, vomiting, constipation, lethargy and a one-year history of increasing abdominal mass. Physical examination revealed a 20 cm palpable mass extending from the left upper quadrant to the umbilicus. Laboratory investigations demonstrated iron deficiency anemia and CT showed two well-defined foci within the gastric lumen consistent with trichobezoars. She was managed conservatively during her hospital stay and discharged home with a plan for elective laparotomy. We present this case to discuss the management of trichobezoars and to highlight the importance of early recognition of recurrence to avoid severe complications.

Gastric bezoar is a concretion of undigested material found in the stomach and is classified by its composition. Patients may remain asymptomatic or present with a variety of gastrointestinal symptoms. Upper gastrointestinal endoscopy is required to establish the diagnosis. Treatment options include chemical dissolution, endoscopic removal, or surgical removal. Here, we present a rare case of gastric bezoar in a patient with a remote history of bariatric surgery presenting with acute weight loss.

Bezoars are conglomerates of indigestible foreign material that can be found in the gastrointestinal tract. Gastric ulcer, gastrointestinal perforation, and intestinal obstruction are the main complications. Acute pancreatitis secondary to bezoar is rare. Here, we present a rare case of a migratory gastric bezoar complicated by acute pancreatitis and small bowel obstruction after dissolution therapy.

A-65-year-old woman underwent gastroscopy because of epigastric pain, which revealed a huge bezoar and a gastric ulcer 10 d prior. The patient was discharged with a prescription of drinking 1 L Coca-Cola daily for 6 d, without repeat gastroscopy. However, she suddenly developed epigastric pain, nausea and vomiting for 3 d. Abdominal computed tomography (CT) revealed mild inflammation of the pancreas. Magnetic resonance cholangiopancreatography showed no abnormalities in the pancreatic duct or common bile duct. The nasogastric tube still showed drainage of more than 1.6 L of dark fluid each day after symptomatic treatment. Abdominal CT re-examination suggested intestinal obstruction. Esophagogastroduodenoscopy revealed a huge yellowish hard mass in the jejunal lumen, and we used the basket and net to fragment the bezoar. She was discharged with a good outcome.

Endoscopic therapy is the first choice for gastric bezoars. When mechanical disintegration cannot be achieved, timing of repeat endoscopy is important during Coca-Cola dissolution therapy.

• Bezoar
• Intestinal obstruction
• Acute pancreatitis
• Dissolution therapy
• Endoscopy
• Case report

• conservative management
• gastric phytobezoar

• Rapunzel syndrome
• children
• trichobezoar
• trichophagia
• trichotillomania

The aims of this study were to summarize the clinical characteristics and risk factors for bezoars and to analyze the effectiveness and safety of the endoscopic treatment of bezoars.

From January 2015 to February 2020, 75 of the 23 950 patients who underwent gastroscopic examination in our medical center were diagnosed with bezoars. Clinical and treatment information for these patients was collected retrospectively and analyzed.

The detection rate of bezoars was 0.31%. Risk factors included the time of year (autumn and winter seasons), alcohol consumption, hypertension, diabetes, and residing in the Mentougou district, which is rich in hawthorn and persimmon. Abdominal pain (90.7%) and bloating (80.0%) were common clinical symptoms of bezoars, while gastric mucosa erosion (90.7%) and gastric ulcers (60%) were common manifestations on endoscopic examination. Six patients with bezoars were successfully discharged after drug treatment. The success rate for bezoars treated by gastroscopic lithotripsy was 94.2% (65/69 patients). The factors affecting the therapeutic effect of bezoars include patient age (P=0.025) and bezoar size (P=0.042). Patients with bezoars larger than 9 cm were significantly more likely to have intestinal obstructions than were patients with bezoars smaller than 9 cm (P<0.001).

Bezoars mainly occur in elderly patients with diseases such as gastrointestinal dyspraxia and diabetes, and are most common in hawthorn and persimmon producing areas. Endoscopic treatment is safe and effective for bezoars in general, but intestinal obstruction should be considered for bezoars larger than 9 cm.

• Bezoar
• earth-eating
• eating disorder
• obsessive-compulsive disorder
• pica

• gastroduodenal disease

A gastric bezoar is a compact mass of indigestible foreign materials that accumulate and consolidate in the stomach; however, it can be found in other sites of the gastrointestinal tract. The causative manner of this condition is complex and multifactorial. The main purpose of the review was to raise awareness among clinicians, particularly gastroenterologists, that patients with certain risk factors or comorbid conditions are predisposed to gastric bezoar formation. Early diagnosis and prompt intervention are crucial to avoid bezoar-induced complications. Upper gastrointestinal endoscopy is the standard diagnostic and therapeutic method for gastric bezoars. However, for large size bezoars, surgical intervention is needed.

Bezoars are rare but may cause gastrointestinal obstruction and ulcers. To the best of our knowledge, only two cases of bezoars in the reconstructed gastric conduit have been reported, but there has been no report on reconstructed gastric conduit obstruction due to bezoars.

A 60-year-old man presented to our clinic with abdominal pain and vomiting that occurred suddenly after dinner. Three years before presentation, he had undergone radical thoracoscopic esophagectomy followed by reconstruction of the gastric conduit through the posterior sternum, for esophageal cancer. Enhanced computed tomography scans showed distension of only the gastric conduit without ischemia and distension of the small intestine. According to our findings, we initially diagnosed the patient with postoperative intestinal obstruction caused by adhesions. After conservative treatment failed, the patient underwent an endoscopic study that showed a bezoar at the pylorus ring. We initially failed to remove the bezoar endoscopically because of its large size; hence, we attempted enzymatic dissolution. Three days after the first endoscopic study, the bezoar was disintegrated using a snare and extracted during a second endoscopy. The patient recovered uneventfully and presented with no complications during the 1-year follow-up interval.

In cases wherein the discharge of materials in the reconstructed gastric conduit is delayed, bezoars should be considered in the differential diagnosis, and an endoscopic study should be performed to verify the cause of obstruction.

• Bezoar
• Esophageal cancer
• Esophagectomy
• Obstruction
• Reconstructed gastric conduit

• bezoar
• phytobezoar

Seed bezoars are a subcategory of phytobezoars, caused by consumption of indigestible vegetable or fruit seeds. We present the case of a 64-year-old male patient, who presented at the Emergency Department, complaining of constipation, tenesmus and rectal pain. History and digital examination revealed a rectal seed bezoar due to sunflower seeds, impacted in the lower rectum. The patient underwent manual disimpaction under general anaesthesia, after conservative measures failed. Seed bezoars represent a different pathophysiological process compared to fibre bezoars. They are usually found in the rectum of patients without predisposing factors, causing constipation and anorectal pain. History taking and digital rectal examination are the cornerstones of diagnosis, with manual disimpaction under general anaesthesia being the procedure of choice.

• Bezoar
• phytobezoar
• seed

• LCIG
• Parkinson’s disease
• gastrostomy
• granulation
• trouble

• Bezoar
• endoscopy
• ileus
• intestinal obstruction
• phytobezoar

• intestinal obstruction
• long intestinal tube
• nasogastric tube
• phytobezoar
• rhubarb

• Aged
• Bezoars/complications
• Bezoars/physiopathology
• Case-Control Studies
• Chi-Square Distribution
• Decompression, Surgical/methods
• Decompression, Surgical/standards
• Female
• Humans
• Intestinal Obstruction/epidemiology
• Intestinal Obstruction/surgery
• Intestines/pathology
• Intestines/physiopathology
• Intubation, Gastrointestinal/methods
• Intubation, Gastrointestinal/standards
• Male
• Middle Aged
• Postoperative Complications/epidemiology
• Retrospective Studies
• Treatment Outcome