1/9. Bolus obstruction of pouch outlet by a granular bulk laxative after gastric banding.BACKGROUND: constipation is an occasional problem after gastric banding and is often caused by insufficient liquid intake. As a result, the use of laxatives is widespread in such patients. Depending on the laxative, improper use can lead to bolus obstruction above the band, as occurred in this case. Case Report: A 59-year-old female with uncomplicated laparoscopic adjustable gastric banding presented 2 months after surgery with food and liquid intolerance and dysphagia after ingestion of a granular bulking laxative. Despite deflating the band, the bolus could not be washed out. Endoscopic extraction was required, revealing a 4x2 cm bolus of the laxative and a small compression ulcer. DISCUSSION: patients not complying with nutritional recommendations after gastric banding may have insufficient liquid intake and, consequently, constipation. Under these conditions, the use of a granular bulking laxative entails the risk of esophageal obstruction above the band. CONCLUSION: Nutritional counseling after gastric banding should include the recommendation of liquid intake of at least 1.5 l/day. If constipation occurs, osmotic or paraffin oil laxatives should be used instead of bulking laxatives.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
2/9. Use of a mechanical thrombectomy catheter for percutaneous extraction of renal fungal bezoars in a premature infant.Fungal urinary tract infections are commonly encountered in the hospitalized neonate. Although these infections most commonly take the form of cystitis, the infection may be complicated by the formation of fungal bezoars, with subsequent urinary tract obstruction. In certain cases, endosurgical debulking or extraction of the fungal bezoar may be necessary. This is particularly challenging in neonates due to their often-compromised physiologic state and small size. We report a case of a premature infant with bilateral obstructing renal fungal bezoars in whom a percutaneous catheter-based thrombectomy system was used successfully to debulk the fungal burden.- - - - - - - - - - ranking = 5keywords = extraction (Clic here for more details about this article) |
3/9. intestinal obstruction due to phytobezoars of banana seeds: a case report.Phytobezoars are a well-known, though rare, cause of mechanical alimentary tract obstruction. They occur mainly in patients who have undergone abdominal surgery, where most literature reports describe the causes as persimmons and oranges. We report four cases, seen within a period of 19 months in laos, with intestinal obstruction caused by phytobezoars from jungle banana seeds. They had no history of previous gastrointestinal surgery. The recommended therapy in total obstruction is laparotomy, "milking" through the ileocaecal junction, or enterotomy and direct extraction. As recurrence and presentation at multiple sites are possible, all of the gastrointestinal tract should be thoroughly examined intraoperatively.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
4/9. Laparoscopic removal of a large gastric bezoar in a mentally retarded patient with pica.Whereas small gastric bezoars may be removed endoscopically, large bezoars traditionally are removed at laparotomy. We describe a 33-year-old mentally retarded woman with pica syndrome who had experienced episodes of upper abdominal pain and distension of 10 months duration. gastroscopy showed a large bezoar in the stomach, and attempted endoscopic removal was unsuccessful. The patient underwent laparoscopic extraction of the bezoar, which proved to be an ingested glove. She made an uneventful recovery and was discharged home on postoperative day 1. She had no wound complications, and her symptoms had not recurred at a 3-month follow up assessment. The operative technique is described, and the merits of the laparoscopic approach are discussed.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
5/9. Treatment of a gastric bezoar by extracorporeal shock wave lithotripsy.A bezoar of the stomach was diagnosed by X-ray and endoscopy in an 8-year-old boy who presented with intermittent dull epigastric pain. Attempts at endoscopic extraction failed because of the size and hardness of the bezoar. Extracorporeal shock wave lithotripsy was therefore applied using ultrasound to locate the bezoar. Disintegration of the bezoar and spontaneous evacuation of the fragments was achieved.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
6/9. Esophageal bezoar: a rare but distinct clinical entity.A 89 year old female patient presented with severe dysphagia and was suspected to have carcinoma of the esophagus. endoscopy revealed an esophageal phytobezoar which passed down spontaneously after unsuccessful endoscopic extraction attempt. barium swallow study revealed diffuse spasm of the esophagus. A review of English literature revealed only 17 previous cases of esophageal bezoar. Salient features of esophageal bezoars are discussed based on previous reports and the current case.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
7/9. The Rapunzel syndrome. Report of a case and review of the literature.The Rapunzel syndrome, a rare manifestation of trichobezoar, occurs when bolus gastrointestinal obstruction is produced by an unusual trichobezoar with a long tail that extends to or beyond the ileocaecal valve. A five-year-old Jamaican girl presented with this abnormality and was found at laparotomy also to have an ileo-ileal intussusception. For the Rapunzel syndrome, we recommend bezoar extraction at laparotomy via multiple enterotomies. In addition, psychiatric evaluation and therapy is essential due to the commonly associated finding of underlying emotional stress.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
8/9. Gastric bezoar following penetrating abdominal injury. diagnosis and endoscopic therapy.We present a patient who developed a gastric bezoar following extensive penetrating abdominal trauma. Bezoar pathogenesis, diagnosis, and endoscopic therapy are highlighted. Additionally, alternative therapeutic modalities are explored with a review of the literature. Combination endoscopic lavage fragmentation/extraction presents a safe method of bezoar resolution.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
9/9. Small-bowel obstruction during enzymatic treatment of gastric bezoar.A 66-year-old woman had a sudden onset of small-bowel obstruction during enzymatic treatment for gastric persimmon bezoar. Oral enzymatic therapy is the most effective method of treatment for large phytobezoars when endoscopic extraction is not possible. However, this report suggests that a further endoscopic intervention may be necessary in case the dissolved bezoars cause small-bowel obstruction during this form of therapy.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |