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Intestinal obstruction and bezoars

C Escamilla1, R Robles-Campos, P Parrilla-Paricio

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

Journal of the American College of Surgeons
|September 1, 1994
PubMed
Summary
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Bilateral truncal vagotomy plus pyloroplasty and excessive vegetable fiber intake are key factors in bezoar formation. Surgical fragmentation and milking to the cecum is the primary treatment for intestinal bezoars.

Area of Science:

  • Gastroenterology
  • Surgical Pathology

Context:

  • Gastrointestinal bezoars are common, often linked to prior surgical interventions for peptic ulcers.
  • This study reviews 87 cases of intestinal bezoar treated surgically.

Purpose:

  • To identify predisposing factors for bezoar formation.
  • To evaluate the clinical presentation and diagnostic methods for intestinal bezoars.
  • To assess the optimal surgical management strategy for bezoars.

Summary:

  • Previous surgery, particularly bilateral truncal vagotomy with pyloroplasty (75.8%), and high vegetable fiber intake (39.5%) were significant risk factors.
  • Alterations in dentition and mastication also contributed in 24% of cases.
  • Surgical intervention involved fragmenting the bezoar and milking it to the cecum; enterotomy was reserved for irreducible cases due to higher complication rates.

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Impact:

  • Highlights the association between specific surgical procedures for peptic ulcers and bezoar development.
  • Emphasizes the role of diet and mastication in bezoar etiology.
  • Recommends conservative surgical fragmentation over enterotomy for better patient outcomes.