1/8. Childhood trichobezoar.Two cases of trichobezoar with unusual presentation in rural female children are described. The first one in a healthy asymptomatic child with no abnormal psychological behaviour and other one in an emotionally disturbed child with history of trichotillomania. Both were treated surgically with no recurrence. A physical sign of indentibility is discussed and literature is also reviewed.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
2/8. Prickly pear fruit bezoar presenting as rectal perforation in an elderly patient.BACKGROUND AND AIMS: Prickly pear fruit rectal seed bezoars are an extremely rare entity. Only nine cases of rectal seed bezoar have been reported, only one of which involved the prickly pear fruit seed. Furthermore, to our knowledge, this is also the first reported case presenting as rectal perforation. patients AND methods: We report a case of prickly pear fruit bezoar occurring in the elderly whom presented with rectal perforation. Consistent with physical signs, laboratory results, and radiological findings the patient was diagnosed with acute perforation of the rectum. A Hartman procedure was performed, and a colostomy was placed. RESULTS: Currently there are very few data regarding seed bezoars reaching the rectum. There are even fewer data concerning this occurrence in the elderly, and the literature contains no report of this phenomenon presenting or even progressing into perforation. We report this rare entity to the existing literature. CONCLUSION: We report a rare but important case. A prickly pear fruit phytobezoar presenting as rectal perforation. This case may add to the increasing awareness of the danger associated with ingestion of certain foodstuffs. The previously benign sunflower and psyllium seeds are now known to cause bezoar. We feel that the prickly pear fruit should join this small but important list.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
3/8. Trichobezoar--a condition to think of in case of mobile abdominal mass.A twenty year old girl was referred to the surgical out-patients clinic with a history of intermittent epigastric pain and vomiting of five months duration. The patient enjoyed good health prior to this and her past medical history was uneventful. Findings on physical examination included pallor, patchy alopecia and a soft mobile, non-tender mass in the epigastrium and left upper quadrant of the abdomen. When questioned she admitted to a history of trichophagia for as long as she could recall. A provisional diagnosis of gastric trichobezoar was made. Radiological investigations included an abdominal ultrasound which showed a large ill-defined mass lesion with poor transonic features, situated in the upper abdomen and extending from the left upper quadrant across the midline to the liver margin. barium meal revealed that the greater part of the lumen of stomach was occupied with material of an indeterminate nature. Her haematological investigations showed Haemoglobin 9.5 gm/dl and Leucocyte Count 9.0 x 10(9)/L. Her urea and electrolytes were within normal range. At laparotomy a large hair ball extending from the stomach into the duodenum and proximal jejunum was removed through a vertical gastrotomy incision. The patient had a satisfactory post-operative convalescence and was discharged two weeks later.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
4/8. Small bowel phytobezoar mimicking presentation of Crohn's disease.A case of small bowel phytobezoar formed from unusual ingested vegetation is described. The patient presented with recurrent subacute obstruction and a right iliac fossa mass mimicking the presentation of Crohn's disease. None of the usual gastrointestinal disorders that predispose to bezoar formation were present. The phytobezoar passed spontaneously following small bowel enema and colonoscopy. It is possible that relaxation of the gut secondary to the antispasmodics administered at investigation or the physical disturbance during these procedures enabled migration through the ileocecal valve. Antispasmodics may be of use in the conservative management of bezoars obstructing otherwise normal bowel.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
5/8. Trichobezoar: two case reports--a new physical sign.Two cases of trichobezoar in young emotionally disturbed West Indian children are reported; one was due to blanket-chewing and the other was due to trichotillomania. Both were treated successfully by surgery. The previously undescribed physical sign of indentability is introduced. The literature on trichobezoars is reviewed.- - - - - - - - - - ranking = 5keywords = physical (Clic here for more details about this article) |
6/8. Medication bezoar: intestinal obstruction by an isocal bezoar. Case report and review of the literature.Medications may occasionally obstruct the gastrointestinal tract by virtue of their physical mass. Obturative obstruction of the alimentary tract is reportedly caused by an increasing number of medications, including hydroscopic bulk laxatives, cholestyramine, nonabsorbable antacids, and vitamin C tablets. Inspissated Isocal tube feedings caused jejunal obstruction in a postoperative patient. Medication bezoars are a rare cause of intestinal obstruction that may result in significant patient morbidity, including bowel necrosis, perforation, and peritonitis. The radiographic appearance may mimic an abdominal abscess.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
7/8. Medication bezoars: a literature review and report of a case.OBJECTIVE: To describe a case of a medication bezoar and to review the clinical presentation, diagnosis, risk factors, pathogenesis, complications, and treatment of medication bezoars. DATA SOURCES AND STUDY SELECTION: A medline search (January 1966-December 1997) of the English-language literature pertaining to bezoars was performed. These articles were scanned, and literature specifically discussing medication bezoars was selected. Additionally, the reference sections of pertinent review and case reports were scanned for additional relevant literature. DATA SYNTHESIS: bezoars are concretions of foreign material within the body. In the case of medication bezoars, these concretions occur within the digestive tract and are composed of medications and/or medication vehicles. Rarely, however, is bezoar formation solely due to a medication. In nearly all reported cases the patient had one or more significant risk factors that contributed to bezoar formation. The exact method by which medications bezoars form is dependent on the particular type or combination of medications involved. Bezoar formation may be associated with significant complications for the patient due to the presence of the bezoar and because of the effects of the medication within the bezoar. Treatment of medication bezoars depends largely on the location and the cause of the bezoar. CONCLUSIONS: Medication bezoars are a rare but potentially serious complication of medication use in certain patients. These patients often present with signs and symptoms consistent with an obstruction of the gastrointestinal tract and represent an even greater diagnostic challenge due to the rarity of this complication. These patients also face significant complications from both the bezoar and the medication within the bezoar. To date, treatment of medication bezoars involves mainly physical manipulation of the bezoar through lavage, endoscopic removal, or, in most cases, surgical removal.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
8/8. trichotillomania resulting in a trichobezoar: a case report.This paper presents a case of a 19-year-old, 10 1/2-week-pregnant woman with trichotillomania that resulted in a trichobezoar. The case illustrates typical presentation, patient behavior, symptomatology, and physical findings of patients with trichobezoars. The hypothesized methods for trichobezoar formation, complications, and treatment are discussed. The diagnostic criteria, epidemiology, and treatment of trichotillomania are also discussed.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |