Gastric Bezoar: Retrieve it, Leave it, or Disbelieve it?
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Read the article on pubmed.ncbi.nlm.nih.gov ↗Article · Apr 2021 · 1 min read
In brief
In brief
Retrospective study of 30 pediatric patients with gastric bezoars reveals phytobezoars are likely under-reported, with dysautonomia and underlying GI disorders as potential risk factors. Most cases were successfully treated with endoscopic removal using Roth net retrieval, with symptom improvement at follow-up and minimal recurrence.
Written by the GCMD Library team from the article.
Objectives: To determine the demographics, potential risk factors, endoscopic interventions and outcomes relating to gastric bezoars in pediatric patients; and comparing results with previously published literature.
Methods: Retrospective series by chart review of patients identified by International Classification of Diseases-9 codes 938 and 935, using the following Medical Subject Headings: 1, term bezoar; 2, Keywords gastric bezoar∗ or gastric foreign body∗.
Results: Thirty pediatric patients between ages of 2 to 18 years were found with gastric bezoars, with a female predominance. Majority had a phytobezoar. Six patients were diagnosed with dysautonomia, implying possible role of autonomic dysfunction contributing to abnormal gastric retention. Frequent symptoms included abdominal pain, nausea and vomiting, a decrease in appetite, and unintentional weight loss. A higher prevalence of underlying gastrointestinal disorders was found in those with bezoars. Nuclear medicine gastric emptying scan performed in 13 children was significantly abnormal in only 4 of these children. Most patients were treated with endoscopic removal of the bezoar. Endoscopic removal was accomplished by Roth net, generally requiring multiple passes. At follow-up, most of the children had improvement of symptoms, with bezoar recurrence in 1 patient.
Conclusions: This is to our knowledge the largest series of gastric bezoars in pediatrics. On the basis of our review, phytobezoars may be under-reported in pediatrics. Bezoars should be considered in children presenting with chronic abdominal pain, nausea, and vomiting; even in developmentally normal children and those with normal gastric emptying. We suggest that dysautonomia and underlying gastrointestinal disorders may be potential risk factors.
DOI: 10.1097/MPG.0000000000002923