Esophagogastric polyurethane bezoar complicated by stomach wall microperforation and acute peritonitis: case report
- PDF / 876,868 Bytes
- 4 Pages / 595.276 x 790.866 pts Page_size
- 20 Downloads / 187 Views
Open Access
CASE REPORT
Esophagogastric polyurethane bezoar complicated by stomach wall microperforation and acute peritonitis: case report Krzysztof Ziaja1,2, Jerzy Chudek3* , Aleksander Chlubek2, Mariola Sznapka4, Tomasz Toborek2,3 and Damian Ziaja1,5
Abstract Background: Bezoars are collections of indigestible material in the gastrointestinal tract, mostly described in children. Polyurethane “plastobezoars” consisting of composites used in the construction industry are rarely described bezoars formed in the esophagus and stomach, causing gastrointestinal obstruction, usually necessitating gastrectomy. We describe an unusual presentation of polyurethane bezoar with a volcanic rock consistency, that caused gastrointestinal obstruction and perforation of the stomach wall. Case presentation: A 39-year-old man, a construction worker, was referred with signs and symptoms of high gastrointestinal obstruction and abdominal pain. Esophagoscopy revealed a foreign body in the esophagus, 20 cm from the incisor line, causing its obstruction. The attempt to collect the material with forceps failed as the material was too hard. Spiral computed tomography visualized a wide, gas-filled esophagus and a large stomach. The patient with symptoms of acute peritonitis was operated. There were several microperforations of the stomach wall, caused by sharp bezoar fragments that filled the upper one-third of the stomach and lower part of the esophagus. After a longitudinal stomach incision, the bezoar was bluntly dissected from the wall and removed, and the stomach microperforations were closed by wall duplication. After the operation, the patient confessed to drinking, of his own free will, a two-component building foam used to seal pipes. The patient started normal feeding on the 4th day and was discharge home. Conclusions: Polyurethane bezoars may cause stomach wall perforation and acute peritonitis. Computed tomography has limited usefulness in patients with polyurethane bezoars due to their low specific weight. Keywords: Polyurethane bezoars, Stomach perforation, Acute peritonitis, Case report Background Bezoars are collections of indigestible material in the gastrointestinal tract, mostly described in children. Current classification of bezoars, divided into four groups: *Correspondence: [email protected] 3 Department of Internal Diseases and Oncological Chemotherapy, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland Full list of author information is available at the end of the article
phytobezoars, trichobezoars, lactobezoars, and pharmacobezoars, is incomplete. Since 2011, there have been three published case reports of bezoars consisting of composites used in the construction industry as binders or fillers [1–3]. These polyurethane “plastobezoars” formed in the esophagus and stomach were the cause of obstruction, usually necessitating gastrectomy [2, 3]. Endoscopic removal of bezoar material was reported only by Girardin et al. [1].
© The Author(s) 2020. Open Access This article is li
