Disease relevance of Bezoars

• Previous published clinical observations claim that Gastrografin, a hyperosmolar gastrointestinal water-soluble contrast agent, speeds the resolution of postoperative ileus, barium impaction ileus, adhesive small-bowel obstruction, and intestinal obstruction caused by parasites and bezoars [1].
• Gastric bezoars were observed after esophageal variceal injection of polidocanol in 5 of 56 patients with alcoholic cirrhosis treated by endoscopic sclerosis [2].
• Acute renal failure in a neonate due to pelviureteric candidal bezoars successfully treated with long-term systemic fluconazole [3].
• Renal excretion of oral gastrografin seen on an abdominal film in a patient with incomplete intestinal obstruction due to multiple bezoars [4].
• We present an interesting case of phenytoin toxicity and suggest that formation of a bezoar may be one possible answer to prolonged toxicity [5].

High impact information on Bezoars

• Sucralfate bezoar [6].
• Procardia XL bezoar [7].
• Enteric-coated aspirin bezoar: elevation of serum salicylate level by barium study. Case report and review of medical management [8].
• We discovered an unusual bezoar in a previously healthy man who had been ingesting large amounts of a vegetable-derived oil touted to contain lecithin, which he purchased from health food stores in the belief that it had beneficial effects in lowering cholesterol levels and improving memory [9].
• Polystyrene bezoar in a patient with polystyrenomania [10].

Chemical compound and disease context of Bezoars

• Metoclopramide in the treatment of gastric bezoars [11].
• For example, Bezoar Bovis contained much more taurine relative to the FAA and TAA content compared with other crude drugs, and kokurozin contained much more TAA and much less secondary amino acids relative to TAA compared with koukuzin [12].
• If candidal bezoars are found with pelvic obstruction, we suggest to start treatment by the insertion of bilateral nephrostomy catheters and local irrigation with amphotericin B in combination with systemic antifungal agents, aiming at both the restoration of renal function and the eradication of the fungal infection [13].
• CONCLUSION: Symptoms of trichobezoars are nonspecific and may mimic those of other pathological gastro-intestinal conditions [14].
• Colonic medication bezoar from extended-release nifedipine and procainamide [15].

Anatomical context of Bezoars

• When associated with a candidal bezoar in the urinary tract, candiduria is usually treated by systemic amphotericin B and flucytosine plus local irrigation with amphotericin B [16].

Gene context of Bezoars

• To verify this hypothesis, we sequenced and compared the cytochrome b gene of mitochondrial DNA from six domestic goats and bezoar [17].
• Follow-up of this child and the one we similarly treated for fungal bezoars before, however, shows suboptimal renal function as assessed by the clearance of creatinine and the mercapto acetyl triglycine scan (MAG III) [13].
• OBJECTIVE: To document a case of cecal lecithin-vitamin B12 bezoar formation inducing abdominal discomfort [18].
• Gastroesophageal reflux, altered esophageal pH, and direct instillation of feeding formula through a rent in the feeding tube were additional factors likely leading to bezoar formation in this patient [19].
• Toxic 'sock' syndrome bezoar formation and pancreatitis associated with iron deficiency and pica [20].

Analytical, diagnostic and therapeutic context of Bezoars

• We also summarize the reported cases of esophageal bezoars related to enteral feeding formula, sucralfate, or both [19].
• Once formed, the bezoar can be disintegrated through surgery, by the use of the Water Pik and enzymes during endoscopy, or by treatment with metoclopramide [21].
• The water-extract from "Bezoar bovis", a drug used in Chinese traditional medicine, was examined for its ability to alter the beating pattern of spontaneously contracting cultured embryonic mouse myocardial cells following changes in extracellular calcium (Ca2+) [22].
• An obstructing aluminum hydroxide gel bezoar was first recognized on a retrograde gastrografin study through an ileostomy [23].
• Treatment consisted of surgical removal of the bezoar, together with open placement of nephrostomy tubes, parenteral amphotericin B therapy and peritoneal dialysis [24].

References