Khat induced bezoar; a rare cause of small bowel obstruction:a case report

Effects of khat (Catha edulis) chewing on dry mouth and taste function: a comparative cross-sectional study

OBJECTIVES

The objective of this study was to evaluate oral dryness and the taste sensation threshold (sweet, salt, sour, and bitter) among khat chewers.

METHODS

This cross-sectional comparative study enrolled 140 healthy individuals divided into 2 groups: khat chewers (KCs; n = 73), and non-chewers (NCs; n = 67). Oral dryness was assessed using the Clinical Oral Dryness Score (CODS), whereas taste perception was assessed using the 4 primary tastes: sweet, salty, sour, and bitter, along with the Total Taste Score (TTS), each prepared as 7 chemical solutions representing 7 concentrations. SPSS version 26 was used for data analysis.

RESULTS

Overall, KC revealed significantly higher overall CODS scores compared to NCs (4.26 ± 1.39 vs 2.10 ± 1.15, P < .001). The TTS was significantly lower in KCs (16.52 ± 3.367) compared to NCs (18.87 ± 3.592, P < .001), owing to revealing significantly lower mean taste sensation scores for sweet, salty, and bitter tastes but not for sour taste. Up to 20.5% of KCs had hypogeusia compared with only 4.5% of NCs (P = .005). Multivariate analyses also revealed khat chewing as an independent determinant factor for oral dryness and hypogeusia.

CONCLUSIONS

Chronic khat chewing is associated with mouth dryness and taste impairment, gravely impacting on the patients' quality of life. (Oral Surg Oral Med Oral Pathol Oral Radiol YEAR;VOL:page range).

A plastic bezoar causing bowel obstruction: A case of table cover ingestion

INTRODUCTION AND IMPORTANCE

A bezoar is an indigestible food or other material within the gastrointestinal tract. It can be ingested intentionally or accidentally. The small bowel bezoar prevalence ranges between 0.4 % and 4 %, and the prevalence is less than 0.5 % for gastric bezoars. There are different types of bezoars, but the mention of a plastic bezoar rarely appears in the literature. To our knowledge, this is the first reported case of a plastic bezoar in the Kingdom of Saudi Arabia.

CASE PRESENTATION

A 58-year-old woman was admitted for acute kidney injury, and while working her up, it was discovered that she had a possible foreign body on computerized tomography scan. As a result, she underwent exploratory laparotomy with the findings of plastic foreign objects identified 90 cm from the ileocecal valve and other objects identified in the stomach.

CLINICAL DISCUSSION

The impaction of these materials often occurs in narrow areas such as the lower esophagus, duodenum, ileocecal valve or even the anus. In this unique case, two points of impaction were noted: the first was in the small bowel and the second point in the stomach. The approach to such cases could be Endoscopic versus surgical or even chemical dissolution as a choice of treatment is dependent on multiple factors.

CONCLUSION

The approach to these cases is multidisciplinary and depends on the availability of services and resources at the treating hospital. Reporting such cases helps in managing challenging situations. Additionally, a psychiatric assessment is a crucial step.

Gastrointestinal bezoars: Review of the literature and report of a rare case of pumpkin seed rectal impaction

In science, bezoar is a mass of hair or undigested vegetable matter, found in a human or animal's intestines, similar to a hairball. Usually, it is found trapped in every part of the gastrointestinal system and must be distinguished by pseudobezoar which is an indigestive object voluntarily introduced into the digestive tract. The term Bezoar is from Arabic bāzahr, "bezoar" or ultimately from Middle Persian p'tzhl pādzahr, "antidote, bezoar"ægagropile o egagropile It should be a universal antidote that works against any poison, and could neutralize any poison. Otherwise, the name could derive from a kind of Turkish goat whose name is just bezoar. Authors report a case of fecal impaction by pumpkin seeds bezoar with abdominal pain: a difficulty to void with subsequent rectal inflammation and hemorrhoid enlargement was observed. The patient underwent a successful manual disimpaction. Guidelines do not require IRB approval Authors examined the literature about occlusion from bezoar The most common causes of occlusion from bezoar are: a previous gastric surgery such as a gastric band (for weight loss) or gastric bypass, a reduced stomach acid (hypochlorhydria) or decreased stomach size, a delayed gastric emptying, typically due to diabetes, autoimmune disorders, or mixed connective tissue disease. Seed bezoars are usually found in the rectum of patients without predisposing factors, causing constipation and pain. Rectal impaction is common after ingestion of seeds while a true occlusion is rare. Although several cases of phytobezoars composed of various types of seeds are reported in literature, bezoars of pumpkin seeds have rarely been reported.

Transverse colon and omental incarceration in femoral hernia: a case report

A femoral hernia is one of the groin hernias with a high chance of incarceration and strangulation due to its narrow neck. Here, we report a case of transverse colon incarceration. A 65-year-old female patient presented with groin mass that failed to reduce and a dragging pain. Elective open femoral herniorrhaphy was done with the finding of viable incarcerated massive momentum along with transverse colon. Femoral hernias have a female-to-male ratio of about 10:1. Postmenopausal, increasing age, and constipation were some of the risk factors identified in our patient. Various types of organs can be found in the femoral hernia sac but one of the rarely reported organ was found in our case: a transverse colon. Femoral hernia with a large bulky soft mass can get incarcerated easily but relatively less prone to strangulation.