Abstract
Purpose. The aim of this study was to present the computed tomography (CT) findings of bezoars that cause obstruction in the small bowel and to emphasize that some CT findings can be considered specific to some bezoar types. Materials and Methods. The records of 39 patients who underwent preoperative abdominal CT and subsequent operation with a diagnosis of intestinal obstruction due to bezoars were retrospectively analyzed. Results. In total, 56 bezoars were surgically removed from 39 patients. Bezoars were most commonly located in the jejunum (n = 26/56, 46.4%). Sixteen (41.0%) patients had multiple bezoar locations in the gastrointestinal tract. Common CT findings in all patients were a mottled gas pattern and a focal ovoid or round intraluminal mass with regular margins and a heterogeneous internal structure. Furthermore, some CT findings were determined to be specific to bezoars caused by persimmons. Conclusions. Preoperative CT is valuable in patients admitted with signs of intestinal obstruction in geographic regions with a high bezoar prevalence. We believe that the correct diagnosis of bezoars and the identification of their number and location provide a great advantage for all physicians and surgeons. In addition, some types of bezoars have unique CT findings, and we believe that these findings may help to establish a diagnosis.
Highlights
Bezoar is a mass of swallowed foreign indigestible material found within the gastrointestinal tract (GIT)
We evaluated the preoperative Computed tomography (CT) findings of bezoars that cause obstructions in the small intestines, and highlight some special CT appearances that may be useful for differential diagnoses in the preoperative period
The relationship between previous peptic ulcer operation and bezoar formation has been emphasized in the literature [2,3,4, 7]
Summary
Bezoar is a mass of swallowed foreign indigestible material found within the gastrointestinal tract (GIT). Despite the fact that bezoars are a rare cause of intestinal obstruction, this emergency pathology is a frequently encountered problem worldwide [1]. Predisposing factors in bezoar formation include systemic diseases that reduce gastrointestinal motility and previous peptic ulcer surgery [2]. Radiologic findings are very valuable for bezoar diagnosis, because clinical and laboratory findings are similar for bezoars and other causes. Radiographic and ultrasonographic findings have been defined for bezoars [3, 4]. Computed tomography (CT) is superior to other radiologic tools for bezoar diagnosis and differential diagnosis in patients with intestinal obstruction
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