Clinical characteristics and indications for surgery for bezoar-induced small bowel obstruction. Issue 1 (January 2021)

• Record Type: Journal Article
• Authors: Wang, Shuai; Yang, Xiaohui; Zheng, Yixiong; Wu, Yulian
• Is Part Of: Journal of international medical research. Volume 49:Issue 1(2021)
• Publication Date: 2021-01
• Subjects: Bezoar-induced small bowel obstruction -- clinical characteristics -- computed tomography -- surgical indications -- hospital stay -- hospitalization costs; Medicine -- Periodicals; Pharmacology -- Periodicals; 610.5
• DOI: 10.1177/0300060520979377
• Languages: English
• ISSNs: 0300-0605

Abstract

Background: To evaluate the clinical characteristics and indications for surgery for bezoar-induced small bowel obstruction (BI-SBO). Methods: Forty patients with BI-SBO were treated at our hospital from January 2017 to December 2019, and these patients' clinical and computed tomography (CT) data were analyzed. Results: Twenty-seven and 13 BI-SBO patients constituted the non-ST group and ST group, respectively. The clinical manifestations of BI-SBO in both groups were abdominal pain, nausea, vomiting, and lack of defecation. Comparing the non-ST vs ST groups, respectively: mean age (years): 63.15 ± 16.15 vs 60.38 ± 12.47; duration of symptoms (hours): 55.11 ± 44.08 vs 59.33 ± 72.90; mean bezoar length (cm): 5.31 ± 0.74 vs 3.72 ± 0.53; mean bezoar width (cm): 3.74 ± 0.48 vs 2.9 ± 0.64; bezoar CT maximum Hounsfield units (HU): 97.23 ± 12.36 vs 21.11 ± 7.27; total hospital stay (days): 5.56 ± 4.23 vs 7.12 ± 6.12 (mean: 8.62 ± 2.81); and total hospitalization costs (RMB): 6378.02 ± 3015.68 vs 8213.71 ± 5564.29. Mean operation time was 85.00 ± 8.90 minutes, and mean operation blood loss was 32.31 ± 19.64 mL. Bezoars were located 60 to 160 cm from the ileocecal junction. Univariate analysis demonstrated that bezoar length and width and maximum CT value were significant risk factors for surgery. Conclusion: Large bezoar size and high CT values may be indications for surgery. Surgery is necessary and effective when nonsurgical treatment is ineffective.