DOI: 10.12890/2015_000258

An Unexpected Cause of Marked Weight Loss Associated with Vomiting in an Adult Man: Gastric Phytobeozar

Authors

  • Marco Vacante Department of Internal Medicine, University of Catania, Ospedale Cannizzaro, Catania
  • Innocenza Alessandria Department of Internal Medicine, University of Catania, Ospedale Cannizzaro, Catania
  • Emanuela Cataudella Department of Internal Medicine, University of Catania, Ospedale Cannizzaro, Catania
  • Rosangela Fichera Department of Internal Medicine, University of Catania, Ospedale Cannizzaro, Catania
  • Lorenzo Malatino Department of Internal Medicine, University of Catania, Ospedale Cannizzaro, Catania

marcovacante@yahoo.it

Keywords

bezoar, edentulism, vomiting, hyporexia, weight loss

Abstract

Objectives: We present the case of an edentulous 47-year-old farmer referred to our Department of Internal Medicine because of postprandial vomiting, hyporexia, asthenia and weight loss. He ate a mostly vegetarian diet.

Materials and methods: An oesophagogastroduodenoscopy revealed the presence of a phytobezoar at the level of the fundus and body of the stomach. Endoscopic fragmentation and removal of the phytobezoar were unsuccessful and the patient had to undergo open surgery.

Results: Recovery was uneventful and free of complications.

Conclusion: Phytobezoars should be taken into account in the differential diagnosis of unexplained vomiting and weight loss.

View the entire article

Downloads

References

  1. Williams RS. The fascinating history of bezoars. Med J Aust 1986;145:613–614.
  2. Baudamant WW. Memoire sur des cheveux trouves dans l'estomac et dans les intestines grêles. J Med Chir Pharm 1779;52:507–514.
  3. Allan JD, Woodruff J. Starch gastrolith. Report of a case of obstruction. N Engl J Med 1963;268:776–778.
  4. Gaillard M, Tranchart H. Images in clinical medicine. Trichobezoar. N Engl J Med 2015;372:e8.
  5. Hayes PG, Rotstein OD. Gastrointestinal phytobezoars: presentation and management. Can J Surg 1986;29:419–420.
  6. Zhang RL, Yang ZL, Fan BG. Huge gastric disopyrobezoar: a case report and review of literatures. World J Gastroenterol 2008;14:152–154.
  7. Verstandig AG, Klin B, Bloom RA, Hadas I, Libson E. Small bowel phytobezoars: detection with radiography. Radiology 1989;172:705–707.
  8. Kadian RS, Rose JF, Mann NS. Gastric bezoars--spontaneous resolution. Am J Gastroenterol 1978;70:79–82.
  9. Andrus CH, Ponsky JL. Bezoars: classification, pathophysiology, and treatment. Am J Gastroenterol 1988;83:476–478.
  10. Walk L. Phytobezoar in the gastric stump; report of a case and discussion of therapy. Arch Intern Med (Chic) 1949;84:824–835.
  11. Saeed ZA, Rabassa AA, Anand BS. An endoscopic method for removal of duodenal phytobezoars. Gastrointest Endosc 1995;41:74–76.
  12. Mangold D, Woolam GL, Garcia-Rinaldi R. Intestinal obstruction due to phytobezoars: observations in two patients with hypothroidism and previous gastric surgery. Arch Surg 1978;113:1001–1003. DOI: 10.12890/2015_000258 European Journal of Case Reports in Internal Medicine © EFIM 2015.
  13. Rees M. Intussusception caused by multiple trichobezoars: a surgical trap for the unwary. Br J Surg 1984;71:721.
  14. Seyrig JA, Chambon J, Fritsch J, Berger M, Liguory C, Chousterman M. Cholestasis caused by an intradiverticular bezoar. Endoscopic treatment. Gastroenterol Clin Biol 1989;13:741–743.
  15. Ripollés T, García-Aguayo J, Martínez MJ, Gil P. Gastrointestinal bezoars: sonographic and CT characteristics. AJR Am J Roentgenol 2001;177:65–69.
  16. Gayer G, Jonas T, Apter S, et al. Bezoars in the stomach and small bowel--CT appearance. Clin Radiol 1999;54:228–232.
  17. Gáyá J, Barranco L, Llompart A, Reyes J, Obrador A. Persimmon bezoars: a successful combined therapy. Gastrointest Endosc 2002;55:581–583.
  18. Ladas SD, Triantafyllou K, Tzathas C, Tassios P, Rokkas T, Raptis SA. Gastric phytobezoars may be treated by nasogastric Coca-Cola lavage. Eur J Gastroenterol Hepatol 2002;14:801–803.
  19. Heinz-Erian P, Klein-Franke A, Gassner I, et al. Disintegration of large gastric lactobezoars by N-acetylcysteine. J Pediatr Gastroenterol Nutr 2010;50:108–110.
  20. Lee BJ, Park JJ, Chun HJ, et al. How good is cola for dissolution of gastric phytobezoars? World J Gastroenterol 2009;15:2265–2269.
  21. Koulas SG, Zikos N, Charalampous C, Christodoulou K, Sakkas L, Katsamakis N. Management of gastrointestinal bezoars: an analysis of 23 cases. Int Surg 2008;93:95–98.
  22. Blam ME, Lichtenstein GR. A new endoscopic technique for the removal of gastric phytobezoars. Gastrointest Endosc 2000;52:404–408.
  23. Nirasawa Y, Mori T, Ito Y, Tanaka H, Seki N, Atomi Y. Laparoscopic removal of a large gastric trichobezoar. J Pediatr Surg 1998;33:663–665.
  24. Yau KK, Siu WT, Law BK, Cheung HY, Ha JP, Li MK. Laparoscopic approach compared with conventional open approach for bezoar-induced small-bowel obstruction. Arch Surg 2005;140:972–975.
  25. Song KY, Choi BJ, Kim SN, Park CH. Laparoscopic removal of gastric bezoar. Surg Laparosc Endosc Percutan Tech 2007;17:42–44.

Published

2015-12-16

Issue

Vol. 3 No. 1 (2016)

How to Cite

1.
Vacante M, Alessandria I, Cataudella E, Fichera R, Malatino L. An Unexpected Cause of Marked Weight Loss Associated with Vomiting in an Adult Man: Gastric Phytobeozar. EJCRIM [Internet]. 2015 Dec. 16 [cited 2026 Nov. 3];3(1). Available from: https://ejcrim.com/index.php/ejcrim/article/view/258