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Nonpersimmon Gastric Phytobezoar: A Benign Recurrent Condition

Nonpersimmon Gastric Phytobezoar: A Benign Recurrent Condition Abstract • Phytobezoars are intragastric concretions composed of food or persimmon fruit. Previous studies of patients with phytobezoars have had a preponderance of patients with persimmon phytobezoars; little clinical information is available regarding nonpersimmon phytobezoars. We report the cases of 52 patients with nonpersimmon phytobezoars and contrast our experience with that previously reported for patients with persimmon phytobezoars. Our patients experienced pain (67%), nausea and vomiting (50%), diarrhea (13%), and gastric ulcers (14%). No patient with a phytobezoar died. Two thirds of our patients had conditions that could alter gastric motility. Medical therapy successfully dissolved 91% of the phytobezoars. One fifth of our patients had a phytobezoar redevelop. Compared with patients with persimmon phytobezoars, we conclude that patients with nonpersimmon phytobezoars have (1) different symptoms, (2) a low risk of complications or death, (3) effective medical therapeutic options, and (4) a 19% risk of phytobezoar recurrence. (Arch Intern Med 1984;144:959-961) References 1. Raffin BS: Bezoars , in Sleisenger MH, Fordtran JS (eds): Gastrointestinal Disease . Philadelphia, Saunders Co, 1978, pp 787-791. 2. Debakey M, Ochsner A: Bezoars and concretions. Surgery 1938;4: 934-963 3. 1939;5:132-160. 4. Dann DS, Rubin S, Passman H, et al: The successful medical management of a phytobezoar. Arch Intern Med 1959;103:598-601.Crossref 5. Deal DR, Vitale P, Raffin SB: Dissolution of a postgastrectomy bezoar by cellulase. Gastroenterology 1973;64:467-470. 6. Ferrer JL, Norton RA: Dissolution of phytobezoar using pineapple juice. JAMA 1976;236:1578. 7. Madsen R, Skibba RM, Galvan A, et al: Gastric bezoars: A technique of endoscopic removal. Am J Dig Dis 1978;23:717-719.Crossref 8. Wortzel E, Ferrer JP, DeLuca RF: Medical treatment of the postgastrectomy bezoar. Am J Gastroenterol 1977;67:565-569. 9. Pollard HB, Block GE: Rapid dissolution of phytobezoar by cellulase enzyme. Am J Surg 1968;116:933-936.Crossref 10. Cain GD, Moore P, Patterson M: Bezoars: A complication of the postgastrectomy state. Am J Dig Dis 1968;13:801-809.Crossref 11. Papp JP: Endoscopic gastric phytobezoar removal: A four-year experience, abstracted. Gastrointest Endosc 1976;22:232. 12. Brady PG: Gastric phytobezoars consequent to delayed gastric emptying. Gastrointest Endosc 1978;24:159-161.Crossref 13. Zarling EJ, Moeller DD: Bezoar therapy. Arch Intern Med 1981;141: 1669-1670.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Nonpersimmon Gastric Phytobezoar: A Benign Recurrent Condition

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Publisher
American Medical Association
Copyright
Copyright © 1984 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1984.00350170097019
Publisher site
See Article on Publisher Site

Abstract

Abstract • Phytobezoars are intragastric concretions composed of food or persimmon fruit. Previous studies of patients with phytobezoars have had a preponderance of patients with persimmon phytobezoars; little clinical information is available regarding nonpersimmon phytobezoars. We report the cases of 52 patients with nonpersimmon phytobezoars and contrast our experience with that previously reported for patients with persimmon phytobezoars. Our patients experienced pain (67%), nausea and vomiting (50%), diarrhea (13%), and gastric ulcers (14%). No patient with a phytobezoar died. Two thirds of our patients had conditions that could alter gastric motility. Medical therapy successfully dissolved 91% of the phytobezoars. One fifth of our patients had a phytobezoar redevelop. Compared with patients with persimmon phytobezoars, we conclude that patients with nonpersimmon phytobezoars have (1) different symptoms, (2) a low risk of complications or death, (3) effective medical therapeutic options, and (4) a 19% risk of phytobezoar recurrence. (Arch Intern Med 1984;144:959-961) References 1. Raffin BS: Bezoars , in Sleisenger MH, Fordtran JS (eds): Gastrointestinal Disease . Philadelphia, Saunders Co, 1978, pp 787-791. 2. Debakey M, Ochsner A: Bezoars and concretions. Surgery 1938;4: 934-963 3. 1939;5:132-160. 4. Dann DS, Rubin S, Passman H, et al: The successful medical management of a phytobezoar. Arch Intern Med 1959;103:598-601.Crossref 5. Deal DR, Vitale P, Raffin SB: Dissolution of a postgastrectomy bezoar by cellulase. Gastroenterology 1973;64:467-470. 6. Ferrer JL, Norton RA: Dissolution of phytobezoar using pineapple juice. JAMA 1976;236:1578. 7. Madsen R, Skibba RM, Galvan A, et al: Gastric bezoars: A technique of endoscopic removal. Am J Dig Dis 1978;23:717-719.Crossref 8. Wortzel E, Ferrer JP, DeLuca RF: Medical treatment of the postgastrectomy bezoar. Am J Gastroenterol 1977;67:565-569. 9. Pollard HB, Block GE: Rapid dissolution of phytobezoar by cellulase enzyme. Am J Surg 1968;116:933-936.Crossref 10. Cain GD, Moore P, Patterson M: Bezoars: A complication of the postgastrectomy state. Am J Dig Dis 1968;13:801-809.Crossref 11. Papp JP: Endoscopic gastric phytobezoar removal: A four-year experience, abstracted. Gastrointest Endosc 1976;22:232. 12. Brady PG: Gastric phytobezoars consequent to delayed gastric emptying. Gastrointest Endosc 1978;24:159-161.Crossref 13. Zarling EJ, Moeller DD: Bezoar therapy. Arch Intern Med 1981;141: 1669-1670.Crossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: May 1, 1984

References