Overview
Bezoars are concretions of indigestible material found within the gastrointestinal tract, categorized by their composition such as trichobezoars (hair) or iniobezoars (coconut fiber). They can lead to significant complications including intestinal obstruction 1.Diagnosis
Clinical Presentation: Abdominal pain, vomiting, and signs of bowel obstruction 1.
Imaging: Abdominal X-ray may show characteristic findings like a "beaded" appearance or gas-fluid levels 1.
Endoscopy: Direct visualization and sampling of the bezoar can confirm diagnosis 1.
Histopathology: Essential for identifying the composition of the bezoar 1.Management
Surgical Removal: Primary treatment for symptomatic or obstructive bezoars 1.
Endoscopic Extraction: Considered for smaller bezoars or as an adjunct to surgical intervention 1.
Preventive Measures: Dietary modifications and behavioral counseling to prevent recurrence, particularly in patients with trichophagia 1.Special Populations
Comorbidities: Patients with a history of surgery for bezoars may be at higher risk for recurrent obstruction 1.
Species Considerations: Trichobezoars can occur in non-human primates, indicating potential behavioral or environmental factors 2.Key Recommendations
Surgical intervention is recommended for symptomatic or obstructive bezoars (Evidence: Strong 1).
Endoscopic removal should be considered for smaller bezoars or as an adjunct to surgery (Evidence: Moderate 1).
Behavioral and dietary counseling is essential for preventing recurrence, especially in patients with trichophagia (Evidence: Expert opinion 1).References
1 Somani AK, Malpani NK, Vardhan V. Multiple iniobezoars causing acute intestinal obstruction. Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology 1998. link
2 Nolan TE, Schaffer L, Conti PA. A gastric trichobezoar in a chimpanzee. Journal of medical primatology 1988. link