An incidental concurrence causing gastric outlet obstruction
DOI:
https://doi.org/10.18203/2349-2902.isj20213158Keywords:
Gastric outlet obstruction, Bezoar, Acid peptic disease, Carcinoma stomachAbstract
Phytobezoar which is described as an undigested or incompletely digested food. It is an odd cause of gastric outlet obstruction (GOO). The aim of this study is to present and discuss a case of GOO caused by cicatrised duodenal ulcer with a phytobezoar. 71-year-old male, presented with abdominal pain and vomiting (non-bilious) since 3days with peptic ulcer disease for 4 years. Examination and investigations revealed a bezoar requiring emergency surgical intervention. An exploratory laparotomy was conducted. A bezoar was palpated in the stomach and removed through posterior gastrotomy. Vagotomy with Posterior Gastrojejunostomy was done as drainage procedure for cicatrised Duodenal ulcer. GOO caused by phytobezoar can co-exist in patients with previous history of peptic ulcer disease and cicatrised duodenal ulcer. Urgent laparotomy may be indicated.
References
Silva FG, Goncalves C, Vasconcelos H, Cotrim I. Endoscopic and enzymatic treatment of gastric bezoar with acetylcysteine. Endoscopy. 2002;34:845.
Williams RS. The fascinating history of bezoars. Med J Aust. 1986;145(1986):613-4.
Kurguzov. Bezoars as a cause for acute small intestinal obstruction, Khirurgiia (Mosk). 2004;(12):18-21.
Tan F, Mo H, He X, Pei H. Gastroenterology Report. 2020;67:154-6.
Agha RA, Borrelli MR, Farwana R, Koshy K, Fowler A, Orgill DP. For the SCARE Group, The SCARE 2018 statement: updating consensus surgical Case Report (SCARE) guidelines. Int J Surg. 2018;60:132-6.
Samad TW, Shoukat KI. Gastric outlet obstruction: change in etiology. Pak J Surg Gynaecol Obstet. 2007;23:29-32.
Kochhar R, Kochhar S. Endoscopic balloon dilation for benign gastric outlet obstruction in adults. World J Gastrointest Endosc. 2010;2:29-35.
Tan F, Mo H, He X, Pei H. An unusual case of gastric outlet obstruction caused by multiple giant persimmon bezoars. Gastroenterol Rep (Oxf.). 2016;23:pii:gow042.
Mohammed AA, Arif SH, Qadir RH. Surgical extraction of a giant trichobezoar: a rare presentation. Int J Case Rep Images. 2018;9:1-4.
Kramer SJ, Pochapin MB. Gastric phytobezoar dissolution with ingestion of diet coke and cellulase, Gastroenterol Hepatol (N Y). 2012;8:770-72.
Kaplan JM, Lelcuk IS. Persimmon bezoars as a cause of intestinal obstruction: pitfalls in their surgical management. Br J Surg. 1985;72:242-3.
Chiarini BS, Marchegiani C, Corbellini L, Stella S. Endoscopic fragmentation of gastric bezoars as a valid alternative, in selected cases, to traditional surgery. G Chir. 1997;18:485-7.
Kuo JY, Mo LR, Tsai CC, Chou CY, Lin RC, Chang KK. Nonoperative treatment of gastric bezoars using electrohydraulic lithotripsy. Endoscopy. 1999;31:386-8.
Hung FC, Cho CY, Lo CC, Hwang JJ. Giant gastric phytobezoar successfully eradicated by oral intake plus endoscopic injection of coca-cola. J Internal Med Taiwan. 2009;20:2.
Travaglio UE, Lagouvardou E, Caputi Iambrenghi O, Martines G. Successful endoscopic treatment of gastric phytobezoar: a case report, Int. J.Surg. Case Rep. 37 (2017) 45–47.
Ha SS, Lee HS, Jung MK. Acute intestinal obstruction caused by apersimmon phytobezoar after dissolution therapy with Coca-Cola. Korean J Int Med. 2007;22:300-03.
Mohammed AA, Benmousa AA, lmeghaiseeb I. Gastric outlet obstruction. Hepato gastroenterol. 2007;54:2415-20.
Robles R, Parrilla P, Escamilla C, Lujan JA, Torralba JA, Liron R. Gastrointestinal bezoars. Br J Surg. 1994;81:1000-1001.
Hall JD, Shami VM. Rapunzel’s syndrome: gastric bezoars and endoscopic management. Gastrointest Endosc Clin N Am. 2006;16:111-9.
Pitiakoudis M, Tsaroucha A, Mimidis K. Esophageal and small bowel obstruction by occupational bezoar: report of a case. BMC Gastroenterol. 2003;3:13.
