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Cecal vitamin bezoar formation inducing abdominal discomfort
1Department of Pharmacy Services, Sparrow Hospital, Lansing, MI 48912.
Objective:
To document a case of cecal lecithin-vitamin B12 bezoar formation inducing abdominal discomfort.
Design:
Case study.
Setting:
500-bed, community teaching hospital.
Patient:
81-year-old man with a history of multiple abdominal surgeries who presented with a chief complaint of abdominal pain. Flat plate X-ray of the abdomen revealed multiple capsule-shaped objects lodged in the cecum.
Interventions:
Catharsis with bisacodyl, magnesium citrate, NaCl 0.9%; dissolution with heated, dilute barium administered rectally in conjunction with external manipulation; laparotomy.
Main Outcome Measures:
None planned; dissolution or transit of bezoar through gastrointestinal tract desired outcome.
Results/Discussion:
Classification of bezoars and treatment discussed in relation to this case report.
Conclusions:
Medicinal agents have been implicated in bezoar formation. Treatment options have included: cathartics, heated solvent enemas, and external manipulation and surgery.