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Related Experiment Videos

[Bezoar with real and simulated complications].

H J Vonesch, M Ganz

    Deutsche Medizinische Wochenschrift (1946)
    |March 16, 1984
    PubMed
    Summary

    A large phytobezoar caused a gastric perforation mimicry, leading to upper gastrointestinal bleeding. This rare case highlights bezoars as a cause of gastric emergencies.

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    Area of Science:

    • Gastroenterology
    • Surgical Case Reports

    Background:

    • Acute upper gastrointestinal hemorrhage necessitates prompt diagnosis and management.
    • Gastric phytobezoars are rare foreign bodies that can cause significant gastrointestinal pathology.

    Observation:

    • A 64-year-old patient presented with acute upper GI bleeding and radiographic evidence of subdiaphragmatic free air.
    • Clinical examination revealed an unremarkable abdomen, contrasting with imaging findings.
    • Endoscopy was limited by a large coagulum, obscuring the underlying pathology.

    Findings:

    • Surgical exploration revealed a large phytobezoar (15 x 8 x 8 cm) and a benign pressure ulcer.
    • The free air was within the stomach, demarcated by the bezoar, mimicking a perforation.
    • The gastric wall defect was not a true perforation but an ulcerated area associated with the bezoar.

    Implications:

    • This case underscores the importance of considering bezoars in the differential diagnosis of gastric emergencies, especially when imaging findings are atypical.
    • Phytobezoars can present with diverse symptoms and radiographic findings, challenging initial diagnostic assessments.
    • Accurate diagnosis and timely surgical intervention are crucial for managing bezoar-induced gastrointestinal complications.

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