1/52. trichotillomania and trichophagia leading to trichobezoar.A 14-year-old female presented with the complaints of loss of hair, scalp pruritus, and pain in the abdomen. On careful work-up, she was found to have trichotillomania as well as trichophagia. Investigations also revealed a trichobezoar which completely filled the stomach. Hemogram showed moderate hypochromic anemia. Her detailed psychiatric profile showed a few additional features like obsessive hand washing, knuckle cracking, nose picking and body rocking. Her trichobezoar was removed surgically, and she had an uneventful post-operative recovery. She is being maintained on fluoxetine and is doing well. The role of a multi-disciplinary approach to trichotillomania patients is highlighted.- - - - - - - - - - ranking = 1keywords = pain (Clic here for more details about this article) |
2/52. Extended-release nifedipine bezoar identified one year after discontinuation.OBJECTIVE: To report a case of tablet impaction of nifedipine extended-release tablets (Procardia XL) discovered one year after discontinuation of the drug in a patient with peptic stricture. DATA SOURCES: English-language references identified via a medline search from 1966 through September 1998 and bibliographic review of pertinent articles. DATA SYNTHESIS: Extended-release nifedipine has been associated with the formation of medication bezoars in case reports. bezoars are concretions of undigested material within the gastrointestinal (GI) tract. Although they can occur throughout the GI tract, bezoars are most frequently located in the stomach and, rarely, in the duodenum. We report an unusual case of tablet impaction with a gastric outlet obstruction in the duodenal area discovered one year after the patient stopped taking extended-release nifedipine. CONCLUSIONS: Extended-release nifedipine is associated with tablet impaction, even long after discontinuing administration. Although rare, clinicians should be aware of this potential problem when prescribing extended-release medications to patients at risk, and should consider this possible etiology when refractory epigastric pain and weight loss occur.- - - - - - - - - - ranking = 1keywords = pain (Clic here for more details about this article) |
3/52. Laparosopic removal of large gastric phytobezoars.Large gastric bezoars are difficult to remove endoscopically. A 78-year-old man presenting with abdominal pain and loss of appetite for 4 months was admitted and evaluated. gastroscopy disclosed two large phytobezoars within the stomach. Laparoscopic removal was undertaken. The bezoars were removed via a gastrotomy using the three-trocar technique. They were successfully retrieved from the abdominal cavity using an improvised "endobag" made from a simple surgical glove. Such an endobag presents several advantages; they are easy to make, sterile, economical, readily available, disposable, there is ample space to manipulate the specimen within, and there is minimal risk of contamination throughout the procedure. The authors recommend this approach for the treatment of patients with large gastric bezoars in whom laparotomy is indicated.- - - - - - - - - - ranking = 13.781185080853keywords = abdominal pain, pain (Clic here for more details about this article) |
4/52. An intragastric trichobezoar: computerised tomographic appearance.A 26-year-old lady presented with a history of abdominal pain and distension since two months. The ultrasound examination showed an epigastric mass, which was delineated as a filling defect in the stomach on barium studies. The computerised tomographic scan showed a gastric mass with pockets of air in it, without post-contrast enhancement. This case highlights the characteristic appearance on computerised tomography of a bezoar within the stomach, a feature that is not commonly described in medical literature.- - - - - - - - - - ranking = 13.781185080853keywords = abdominal pain, pain (Clic here for more details about this article) |
5/52. Trichobezoar: a rare cause of acute bowel obstruction.A surgically successfully treated case of (2.8 kg) Trichobezoar presenting with severe epigastric pain, vomiting, associated with anemia and dark stool of one days duration. Complicated on admission by an acute intestinal obstruction. There has been no report of such a case from saudi arabia up to the present time. The presenting symptoms and signs, and management strategies are discussed.- - - - - - - - - - ranking = 1keywords = pain (Clic here for more details about this article) |
6/52. Gastric phytobezoar associated with impaired gastric motility in a patient with spinal cord injury.Impaired gastrointestinal motility as a result of interruption of sympathetic outflow is a common occurrence in the spinal cord injury (SCI) population. In addition, frequent use of medications with anticholinergic properties in this population results in further impairment of peristalsis resulting in gastrointestinal stasis. Since SCI patients often lack sensation below the level of injury, they may present with vague symptoms, which complicates the diagnosis of intestinal obstruction. We report the first case of gastric phytobezoar in a patient with T4 asia A paraplegia who presented with vague upper abdominal discomfort, anorexia, weight loss, and vomiting. Because mortality rates can be as high as 30% if phytobezoars remain untreated, gastrointestinal phytobezoars should be considered in the differential diagnosis of abdominal discomfort in SCI patients. Etiologic factors for phytobezoars are discussed for the general population and in particular, for patients with SCI.- - - - - - - - - - ranking = 0.098779838808667keywords = upper (Clic here for more details about this article) |
7/52. Gastric trichobezoar: an important cause of abdominal pain presenting to the pediatric emergency department.abdominal pain is a common presenting complaint of children seen in urgent care settings. It is the manifestation of a wide variety of disease processes ranging from benign to immediately life-threatening. Gastric bezoars are among the etiologies of chronic childhood abdominal pain that, when undiagnosed, may result acutely in serious complications, including gastric ulceration, bleeding and perforation, intussusception, and small bowel obstruction. To reinforce the importance of including this entity in the differential diagnosis of abdominal pain, we present the case of a 10-year-old girl with a history of chronic epigastric complaints who was ultimately presented with acute small bowel obstruction following fragmentation and distal migration of her gastric trichobezoar. Finally, we review and briefly summarize the current literature regarding the etiology, diagnosis, and management of this disorder in children.- - - - - - - - - - ranking = 83.687110485116keywords = abdominal pain, pain (Clic here for more details about this article) |
8/52. Pharmacobezoar complicating treatment with sodium alginate.We encountered a gastric bezoar that had developed in a 9-year-old girl treated with sodium alginate (Alloid G) for acute gastritis associated with systemic lupus erythematosus. A hard mass palpated in the left upper abdomen proved, upon gastric endoscopy, to be an intragastric foreign body. sodium alginate was detected in an analysis of a sample from this bezoar. In an in vitro simulation, sodium alginate solidified when mixed with the patient's other medicines. The bezoar caused no complications, and disappeared spontaneously after discontinuation of the medications. This case indicates that this sodium alginate preparation, Alloid G, can be a cause of pharmacobezoar.- - - - - - - - - - ranking = 0.098779838808667keywords = upper (Clic here for more details about this article) |
9/52. Phytobezoars as a cause of small bowel obstruction associated with a carcinoid tumor of the ileocecal area.Carcinoid tumors are slowly growing malignant neoplasms associated with an indolent clinical course. About 60% of such tumors are located within the gastrointestinal tract. We describe an unusual case of small bowel obstruction associated with a carcinoid tumor of the ileum. A 70-year-old woman was presented with abdominal pain, vomiting, and clinical signs of mechanical bowel obstruction. X-ray and CT-scan of the abdomen showed hydroaeric levels and the presence of intraluminal hyperdense "stones", presumably of gallbladder origin. A diagnostic laparotomy revealed that a large part of the terminal ileus was edematous, with prominent evidence of intestinal loop adhesions. The edematous part of the ileum was resected. Incision of the intestinal wall revealed a 2-cm soft mass at 8 cm from the ileocecal valve, where the presence of ten fruit pits obstructed the intestinal cavity. Histopathological examination confirmed the diagnosis of a carcinoid tumor. An interesting case of small-bowel obstruction with a double cause is presented: an ileal carcinoid and fruit pit bezoars. The pathophysiology of the obstruction is discussed.- - - - - - - - - - ranking = 13.781185080853keywords = abdominal pain, pain (Clic here for more details about this article) |
10/52. A case report on bezoar.A nine years old girl was admitted into the paediatric surgery word of Dhaka Medical College Hospital (DMCH) with upper abdominal mass and discomfort, was diagnosed radiologically as a case of gastric bezoar which was further confirmed by endoscopy as trichobezoar (hair ball). The girl was undergone laparotomy and trichobezoar was removed from stomach by gastrostomy. After ten days of operation she became well and was discharged from the hospital.- - - - - - - - - - ranking = 0.098779838808667keywords = upper (Clic here for more details about this article) |
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