Beroars are the most common foreign bodies of the gastrointestinal tract. Clinical manifestations vary
depending on the location of bezoar (BZ) from no symptoms to acute abdominal syndrome. When located
in the small bowel, they frequently cause small bowel obstruction (SB0). Diagnosis at an early stage
is important to avoid their mortality and associated morbidity. We reviewed the clinical data, imaging
findings, operative and post-operative data of 11 patients with surgically verified intestinal BZs to assess
the value of imaging studies-conventional abdominal radiographs, ultrasonography (US), and computed
tomography (CT) - in the diagnosis of intestinal BZs. Intestinal obstruction was the presenting condition
in 10 of the 11 patients and BZ-induced SBO was confirmed in these patients. Surgery proved that all BY s
were of phytobezoar (PBZ) type and all were of intestinal origin (10 in the small intestine and one in the
large intestine), of those of small intestinal origin, 8 were in the ileum and 2 were in the jujenum. Different
imaging techniques were conclusive for BZ in 10 of the 11 patients and the imaging findings coincided
with the operative data in these patients. Abdominal radiographs and US were performed in all patients,
abdominal radiographs revealed BZs in 2 patients, US in 8 and CT scan was performed in 10 patients and
revealed BZs in 9.Barium study confirmed the presence of BZ in the only patient who performed such
examination. Thus, imaging studies mainly US and CT were reliable methods for diagnosing intestinal BZs
and most BZs have characteristic US and CT imaging features. CT is more accurate and may be considered
the imaging technique of choice for confirming a diagnosis of intestinal BZs. Because the diagnosis of a
BZ as the cause of intestinal obstruction is important as it modifies the approach to treatment, radiologists
should be aware of the possibility of BZs in the differential diagnosis of all patients having radiological and
clinical features of SBO.
Key words Bezoar, phytobezoar, small bowel obstruction, US, CT. |
