Ileus due to bezoars
Tamer Çolakoğlu, Ali Ezer, Sedat Belli, Özgür Aytaç, Alper Parlakgümüş, Sedat Yıldırım
Başkent Üniversitesi, Genel Cerrahi Anabilim Dalı, Adana, Türkiye
Purpose: To evaluate the predisposing factors, diagnosis and treatment modalities in bezoar patients operated due to ileus.
Patients and Methods: Twenty four patients operated due to bezoars were evaluated retrospectively.
Results: Half of the patients were male. The most important reason for bezoar formation was ulcer surgery in 17 (70.8%) patients. The mean time between the first surgery and bezoar operation was 12 years. Plain graphies were obtained from all patients, with 75% gasfluid levels ratio. Nineteen patients underwent abdominal computer tomography prior to the operation. In 18 (94.7%) patients, computer tomography was successful for bezoar diagnosis. During the operation, bezoars were crushed by fingers and pushed forward to distal bowel segments in 18 (75%) patients, whereas bezoars were removed by enterotomy in the remaining 6 (25%) patients. The localization of the bezoars was in small intestine and in stomach mostly. Seven patients (66.7%) had serious dental problems. Eight patients (33.3%) were diabetic. The duration of hospital stay was significantly higher in enterotomy patients.
Conclusion: In ileus patients with previous gastric surgery or mastication problem or diabetes mellitus, bezoar should be kept in mind as a predisposing factor. Moreover, computer tomography is a very efficient method in bezoar diagnosis. Lastly, if possible, crushing by fingers and pushing forward to the distal bowel segments should be preferred as the surgical procedure for bezoars.
Keywords: Bezoar, ileus, surgery