Phytobezoar

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Bezoar / Phytobezoar : 

Bezoar / Phytobezoar Dr.Harshavardhan

? What is bezoar : 

? What is bezoar A bezoar is a mass found trapped in the gastrointestinal system (usually the stomach),though it can occur in other locations. There are several varieties of bezoar, some of which have inorganic constituents and others organic.

Contents : 

Contents Food bolus imitate true bezoars and are composed of loose aggregates of food items such as seeds, fruit pith, or pits as well as other types of items such as shellac, bubble gum, soil, and concretions of some medications. Pharmacobezoars are mostly tablets or semi-liquid masses of drugs. Normally found following overdose of sustained release medications. Phytobezoars are composed of nondigestible plant material (e.g., cellulose) and are frequently reported in patients with impaired digestion and decreased gastric motility. Diospyrobezoar is a bezoar formed from unripe persimmons (Fuyu / Hachiya). Coca-Cola has been used in the treatment. Trichobezoar is a bezoar formed from hair - an extreme form of hairball. Humans who frequently consume hair sometimes require these to be removed. The Rapunzel syndrome, a very rare and extreme case, may require surgery. A trichobezoar in the trachea is called a tracheobezoar.

Types by location : 

Types by location In the esophagus is common in young children and in horses. In horses, it is known as choke. In the large intestine is known as a fecalith. A trichobezoar in the trachea is called a tracheobezoar.

Symptoms : 

Symptoms Indigestion Stomach upset or distress Nausea Vomiting Diarrhea Pain Gastric ulcers Bad Breath Loss of appetite Weight loss

A trichobezoar in a mentally disturbed 14 year-old girl who was eating her own hair. Note the large filling defect occupying most of the stomach with barium mixed in within the interstices of the mass. A delayed film would show the barium remaining in the bezoar while exiting the rest of the stomach : 

A trichobezoar in a mentally disturbed 14 year-old girl who was eating her own hair. Note the large filling defect occupying most of the stomach with barium mixed in within the interstices of the mass. A delayed film would show the barium remaining in the bezoar while exiting the rest of the stomach

Slide 7: 

Rarely trichobezoars extend beyond the stomach into the bowel (a condition known as Rapunzel syndrome)

Treatment : 

Treatment The bezoar may need to be surgically removed (especially trichobezoars which tend to be large). Sometimes small bezoars can be removed through a scope placed through the mouth and into the stomach (similar to an EGD procedure). Then, follow the prevention measures described.

Slide 9: 

X-ray of Abdomen showing a large homogenous soft tissue density overlying stomach

Slide 10: 

CT Scan of Abdomen with contrast showing a well defined, oval shaped stomach mass with air bubbles retained in the interstices suggestive of a gastric bezoar.

Slide 11: 

Gastric Trichobezoar confirmed by upper endoscopy. A mass made up of hair and other fibrous material was directly visualized to occupy the entire stomach.

Slide 12: 

Gastric Trichobezoar with duodenal tail. A dark greenish black mass of hair bearing the shape of the stomach, with a slimy surface and a strong odor was removed by gastrotomy

Slide 13: 

Post-operation abdominal x-ray.

Slide 14: 

Nice tasty Fruit ah? Do u know its name? Persimmons Diospyrobezoar is a bezoar formed from unripe persimmons (Fuyu / Hachiya)

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