Bezoar
Background
Stomach anatomy
- Mass within the gastrointestinal system
- Made up of organic or inorganic material
- Commonly from eating hair or indigestible materials
- Risk factors include intellectual disability or emotional disturbance
- More common females aged 10 to 19 years of age
Risk Factors
- Gastric dysmotility
- Gastric outlet obstruction
- Dehydration
- Medications
- Anticholinergic
- Opiates
Types of Bezoars
- Food boluses
- Lactobezoar (seen in premature infants receiving formula)
- Pharmacobezoars (medications, especially overdoses of sustained-release medications
- Phytobezoars (indigestible plant material)
- Trichobezoar (hair)
Clinical Features
- Indigestion
- Abdominal pain
- Nausea and vomiting
- Diarrhea
- Gastric ulcers
Differential Diagnosis
Epigastric Pain
- Gastroesophageal reflux disease (GERD)
- Peptic ulcer disease with or without perforation
- Gastritis
- Pancreatitis
- Gallbladder disease
- Acute cholecystitis
- Cholangitis
- Symptomatic cholelithiasis
- Acalculous cholecystitis
- Myocardial Ischemia
- Splenic Infarctionenlargement/rupture/aneurysm
- Pericarditis/Myocarditis
- Aortic dissection
- Hepatitis
- Pyelonephritis
- Pneumonia
- Pyogenic liver abscess
- Fitz-Hugh-Curtis Syndrome
- Hepatomegaly due to CHF
- Bowel obstruction
- SMA syndrome
- Pulmonary embolism
- Bezoar
- Ingested foreign body
- See Nausea and vomiting
Management
- Removal either endoscopically if small but may require surgical removal when large
See Also
References
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