“Bezoar” comes from the Persian, means “protection from poison.” Literally, bezoar is a mass found trapped in the gastrointestinal system like stomach and small intestine. A bezoar in the esophagus is common in young children. The bezoars that can be found in the large intestine is known as ‘faecalith’. Bezoars were important because they were believed to have the power of a universal antidote against any poison where drinking glass which contained a bezoar would neutralize any poison poured into it.
Types of bezoars:
- trichobezoars – hair balls
- phytobezoars – food balls
- lactobezoars – milk or formula in infants
- Pharmacobezoars - mostly consists of tablets or semi-liquid masses of drugs
- foreign body bezoars
Clinical features:
- vomiting
- abdominal distention
- pain
- severe halitosis (bad breath)
- weight loss
- the patient might present with history of pica - pica is a medical disorder characterized by an appetite for largely non-nutritive substances. Some people will describe it as “craving”, especially if it occurs during pregnancy.
- Patchy baldness – clue for trichobezoar
- Abdominal mass – may be palpated over the epigastrium or left upper quadrant of the abdomen
Investigations:
- Plain radiographs
- radiographic contrast studies – the mass might be demonstrated
- upper endoscopy – can be both diagnostic and therapeutic
- for children that noted to have bezoars, they should be rule out for pica, irod deficiency anemia and lead toxicity
Treatment:
- lactobezoars – withold oral feeding for 48 hours
- bezoars can be removed endoscopically
- surgical intervention will be needed in certain case ( i.e.: trichobezoars)
Reference:
- Clinical Handbook of Pediatrics. 3rd edition. Lippincott Williams and Wilkins. 1999.
- http://en.wikipedia.org/wiki/Pica_(disorder)
- http://en.wikipedia.org/wiki/Bezoar
Under Paediatric, Surgical | Comment now » | Technorati Tags: bezoars, endoscopy, faecalith, halitosis, healt, lactobezoars, Pharmacobezoars, phytobezoars, pica, trichobezoars
