Phytobezoars and trichobezoars - A 10-year experience

Introduction: Bezoars are retained concretions of animal or vegetable material in the gastrointestinal tract. Most bezoars reside in the stomach, but they may be encountered elsewhere. Previous gastric surgery, which has resulted in impaired gastric emptying and/or decreased acid production, is usually the cause of bezoars. Phytobezoars are more common, while trichobezoars are rare. Endoscopy and gastrografin swallow may aid in diagnosis. The treatment of bezoars can be either conservative or surgical. Methods: After searching the computerized medical database, all files of hospitalized patients in the years 1992 to 2002 with the diagnoses "bezoars," "phytobezoars," and "tricobezoars" were evaluated. Results: Eighteen patients had bezoars: 16 had phytobezoars and 2 patients were diagnosed as having trichobezoars. Eleven of the patients had previous gastric operation. All patients but one were treated surgically. Two unusual cases of trichobezoar are presented here. Discussion: Thorough understanding of bezoars can allow the clinician to be especially alert when dealing with those patients most likely to develop them, and thus diagnose the condition at an early stage.