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Gastric surgery and bezoars.

J Cifuentes Tebar1, R Robles Campos, P Parrilla Paricio

  • 1University of Murcia, Virgen de la Arrixaca Hospital, Department of General Surgery, El Palmar, Spain.

Digestive Diseases and Sciences
|November 1, 1992
PubMed
Summary
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Gastrointestinal bezoars are a complication after gastric surgery. Key predisposing factors include specific surgical procedures, diet, and dental issues, with intestinal obstruction being the most common presentation.

Area of Science:

  • Gastroenterology
  • Surgical Pathology

Background:

  • Gastrointestinal bezoars can occur after gastric surgery for peptic ulcers.
  • Understanding predisposing factors and clinical presentation is crucial for effective management.

Purpose of the Study:

  • To analyze factors contributing to bezoar formation post-gastric surgery.
  • To evaluate clinical presentations, diagnostic methods, and treatment strategies for gastrointestinal bezoars.

Main Methods:

  • Retrospective analysis of 56 patients with gastrointestinal bezoars following gastric surgery.
  • Data collected on predisposing factors (surgery type, diet, dentition), clinical presentation, diagnostics, and treatment outcomes.

Main Results:

  • 84% of patients had prior bilateral truncal vagotomy plus pyloroplasty.

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  • Excessive vegetable fiber intake (44%) and poor dentition (30%) were significant predisposing factors.
  • Intestinal obstruction (80%) was the most frequent presentation, diagnosed via clinical data and radiology; endoscopy was key for gastric bezoars.

    • Conclusions:

    • Surgical intervention is required for intestinal bezoars, with non-operative fragmentation and propulsion preferred.
    • Gastric bezoars are best managed conservatively with endoscopic or enzymatic methods; surgery is reserved for treatment failures.