Clinical outcomes associated with treatment modalities for gastrointestinal bezoars

Gut Liver. 2014 Jul;8(4):400-7. doi: 10.5009/gnl.2014.8.4.400. Epub 2014 Jan 14.

Abstract

Background/aims: With technical and instrumental advances, the endoscopic removal of bezoars is now more common than conventional surgical removal. We investigated the clinical outcomes in a patient cohort with gastrointestinal bezoars removed using different treatment modalities.

Methods: Between June 1989 and March 2012, 93 patients with gastrointestinal bezoars underwent endoscopic or surgical procedures at the Asan Medical Center. These patients were divided into endoscopic (n=39) and surgical (n=54) treatment groups in accordance with the initial treatment modality. The clinical feature and outcomes of these two groups were analyzed retrospectively.

Results: The median follow-up period was 13 months (interquartile range [IQR], 0 to 77 months) in 93 patients with a median age of 60 years (IQR, 50 to 73 years). Among the initial symptoms, abdominal pain was the most common chief complaint (72.1%). The bezoars were commonly located in the stomach (82.1%) in the endoscopic treatment group and in the small bowel (66.7%) in the surgical treatment group. The success rates of endoscopic and surgical treatment were 89.7% and 98.1%, and the complication rates were 12.8% and 33.3%, respectively.

Conclusions: Endoscopic removal of a gastrointestinal bezoar is an effective treatment modality; however, surgical removal is needed in some cases.

Keywords: Bezoars; Endoscopy; Surgery.

MeSH terms

  • Abdominal Pain / etiology
  • Aged
  • Bezoars / diagnosis
  • Bezoars / surgery*
  • Endoscopy, Gastrointestinal / methods
  • Female
  • Gastrointestinal Diseases / diagnosis
  • Gastrointestinal Diseases / surgery*
  • Humans
  • Lithotripsy / methods
  • Male
  • Middle Aged
  • Retrospective Studies
  • Treatment Outcome