Clinical characteristics and indications for surgery for bezoar-induced small bowel obstruction

• Published in: Journal of international medical research Vol. 49; no. 1; p. 300060520979377
• Main Authors: Wang, Shuai, Yang, Xiaohui, Zheng, Yixiong, Wu, Yulian
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01.01.2021; Sage Publications Ltd; SAGE Publishing
• Subjects: Bezoars - diagnostic imaging; Bezoars - surgery; Humans; Intestinal obstruction; Intestinal Obstruction - diagnostic imaging; Intestinal Obstruction - surgery; Intestine, Small - diagnostic imaging; Intestine, Small - surgery; Retrospective Clinical Research Report; Retrospective Studies; Risk Factors; Small intestine; Surgery; computed tomography; surgical indications; Bezoar-induced small bowel obstruction; hospital stay; clinical characteristics; hospitalization costs
• ISSN: 0300-0605; 1473-2300
• DOI: 10.1177/0300060520979377

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.