A Single-center 12-year Experience of Patients with Gastrointestinal Bezoars

Diagnosis and treatment of giant colonic fecalith in a child: a case report

Fecaliths are concretions composed of undigested or partially digested substances formed within the gastrointestinal lumen, potentially causing obstruction or partial obstruction. The most common type of fecalith is phytobezoar, composed of plant fibers. Due to their high cellulose, hemicellulose, and lignin content, phytobezoars remain undigested within the stomach and intestines, causing blockage in the narrowest portions of the gastrointestinal tract. Obstructions caused by fecaliths typically occur in the stomach and small intestine, whereas colonic obstructions are rare, particularly in pediatric cases. In this study, we report for the first time a case of colonic obstruction caused by a giant fecalith measuring 6 cm × 6 cm, which was successfully managed by colonoscopy-assisted manual extraction under general anesthesia.

Endoscopic removal of an esophageal bezoar in a patient with jackhammer esophagus

Esophageal bezoars are known to be significantly rarer compared to gastric bezoars. A 68-year-old woman presented with acute chest pain and worsening dysphagia to both solids and liquids, culminating in inability to consume water without vomiting.

Clinical Characteristics of Children With Foreign Bodies in the Digestive Tract and Analysis of Risk Factors for Serious Complications

Foreign bodies (FBs) in the digestive tract are common in children, we analyzed the clinical characteristics of children with FBs in the digestive tract and discuss the risk factors for serious complications. We retrospectively reviewed clinical data of 139 children with FBs in the digestive tract. Based on the severity of complications caused by FBs, the patients were divided into risk and general groups for analysis and comparison. Significant differences were observed in the retention sites of FBs, the diameter of FBs retained in the esophagus, FBs retention time exceeding 24 h, and the absence of witnesses between the 2 groups. Inadequate care, button batteries (BBs), ingested mmFBs, FBs retained in the esophagus, long-term retention, and giant gastric bezoars may cause serious complications. In addition to treating FBs and the complications, clinicians should emphasize the importance of childcare to prevent the ingestion of FBs.

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.

"Bezoar Egg"-A Rare Cause of Small Bowel Obstruction

Small bowel obstruction is a frequent medical condition with various causes, the most common being postoperative adhesions, volvulus, intussusception, hernias, and tumors. A bezoar-induced blockage of the small intestine is a rare condition that accounts for approximately 4% of all small bowel obstruction cases. Herein, we present the case report of a 71-year-old patient with diffuse abdominal pain caused by a small bowel obstruction due to a calcified bezoar (bezoar egg) resulting from a post-radiation intestinal stricture. The patient underwent a small bowel excision with the extraction of the bezoar, after which a full recovery was made.

[A Case of Type II Achalasia Occurring in a Nonagenarian Diagnosed with Acute Food Impaction]

Achalasia is an esophageal motility disorder characterized by loss of esophageal peristalsis and impaired relaxation of the lower esophageal sphincter. Patients with achalasia often complain of persistent symptoms for several years before diagnosis. On the other hand, achalasia diagnosed as a sudden esophageal food impaction is uncommon, and no report has been issued on the diagnosis and successful treatment of achalasia in a 95-year-old patient. We report a case of achalasia diagnosed by high-resolution esophageal manometry and timed barium esophagography after food material removal by endoscopy in a 95-year-old woman who visited the hospital due to sudden esophageal food impaction and was successfully treated by endoscopic balloon dilatation.