Bezoar

Changed by Daniel J Bell, 16 Jan 2018

Updates to Article Attributes

Body was changed:

Bezoars are accumulations of undigestableindigestible contents withwithin the gastrointestinal tract 2

They are known to cause small bowel obstruction and sometimes CT may demonstrate the bezoar as a mass in the obstructed segment of bowel. The bezoar may be outlined by fluid in the proximally dilated small bowel, and the mass may be mottled owing to air trapped within it.

There can beare several subtypes depending ofon the predominant contentscomponents:

  1. trichobezoar: is a a bezoar formed from hair. This has also been called Rapunzel syndrome when the tail of the trichobezoar extends some distance through the small bowel.
  2. phytobezoar: are composed composed of indigestible food material (e.g. cellulose) and are frequently reported in patients with impaired digestion and decreased gastric motility. 
    • diospyrobezoar is a subtype of phytobezoar secondary to the consumption of unripe persimmons 5
  3. pharmacobezoar: (or medication bezoars) are mostly undigested tablets or semi-liquid masses of drugs.
  4. lactobezoar: containing undigested milk curds
Associations
  • previous gastric surgery 2
  • psychiatric illness

History and etymology

Premodern medicine considered bezoars a special kind of stone with antidote properties. Until the 18th century a gold mounted bezoar was included in the crown jewels. Some ancient pharmacopeiaspharmacopoeias list 'unicorn horns' as an acceptable alternative if a bezoar is not available. In the late 15th c., eastern century, Eastern porcupine bezoars were considered especially valuable 4.

Differential diagnosis

See also

  • -<p><strong>Bezoars</strong> are accumulations of undigestable contents with the gastrointestinal tract <sup>2</sup>. </p><p>They are known to cause <a href="/articles/small-bowel-obstruction">small bowel obstruction</a> and sometimes CT may demonstrate the bezoar as a mass in the obstructed segment of bowel. The bezoar may be outlined by fluid in the proximally dilated small bowel, and the mass may be mottled owing to air trapped within it.</p><p>There can be several subtypes depending of the predominant contents:</p><ol>
  • +<p><strong>Bezoars</strong> are accumulations of indigestible contents within the gastrointestinal tract <sup>2</sup>. </p><p>They are known to cause <a href="/articles/small-bowel-obstruction">small bowel obstruction</a> and sometimes CT may demonstrate the bezoar as a mass in the obstructed segment of bowel. The bezoar may be outlined by fluid in the proximally dilated small bowel, and the mass may be mottled owing to air trapped within it.</p><p>There are several subtypes depending on the predominant components:</p><ol>
  • -<strong>trichobezoar:</strong> is a bezoar formed from hair. This has also been called <a href="/articles/rapunzel-syndrome-1">Rapunzel syndrome</a> when the tail of the trichobezoar extends some distance through small bowel.</li>
  • +<strong>trichobezoar:</strong> a bezoar formed from hair. This has also been called <a href="/articles/rapunzel-syndrome-1">Rapunzel syndrome</a> when the tail of the trichobezoar extends some distance through the small bowel.</li>
  • -<strong>phytobezoar:</strong> are composed of indigestible food material (e.g. cellulose) and are frequently reported in patients with impaired digestion and decreased gastric motility. </li>
  • +<strong>phytobezoar:</strong> composed of indigestible food material (e.g. cellulose) and are frequently reported in patients with impaired digestion and decreased gastric motility. <ul><li>
  • +<strong>diospyrobezoar</strong> is a subtype of phytobezoar secondary to the consumption of unripe persimmons <sup>5</sup>
  • +</li></ul>
  • +</li>
  • -<strong>pharmacobezoar:</strong> (or medication bezoars) are mostly undigested tablets or semi-liquid masses of drugs.</li>
  • +<strong>pharmacobezoar:</strong> (or medication bezoars) mostly undigested tablets or semi-liquid masses of drugs.</li>
  • -</ul><h4>History and etymology</h4><p>Premodern medicine considered bezoars a special kind of stone with antidote properties. Until the 18<sup>th</sup> century a gold mounted bezoar was included in the crown jewels. Some ancient pharmacopeias list 'unicorn horns' as an acceptable alternative if a bezoar is not available. In the late 15<sup>th</sup> c., eastern porcupine bezoars were considered especially valuable <sup>4</sup>.</p><h4>Differential diagnosis</h4><ul><li>in small bowel loops consider <a href="/articles/small-bowel-faeces-sign-bowel">small bowel faeces sign</a> (SBFS) <sup>3</sup>
  • +</ul><h4>History and etymology</h4><p>Premodern medicine considered bezoars a special kind of stone with antidote properties. Until the 18<sup>th</sup> century a gold mounted bezoar was included in the crown jewels. Some ancient pharmacopoeias list 'unicorn horns' as an acceptable alternative if a bezoar is not available. In the late 15<sup>th</sup> century, Eastern porcupine bezoars were considered especially valuable <sup>4</sup>.</p><h4>Differential diagnosis</h4><ul><li>in small bowel loops consider <a href="/articles/small-bowel-faeces-sign-2">small bowel faeces sign</a> <sup>3</sup>
  • -<li><a href="/articles/small-bowel-faeces-sign-bowel">small bowel faeces sign</a></li>
  • +<li><a href="/articles/small-bowel-faeces-sign-2">small bowel faeces sign</a></li>

References changed:

  • 5. Eng K & Kay M. Gastrointestinal Bezoars: History and Current Treatment Paradigms. Gastroenterol Hepatol (N Y). 2012;8(11):776-8. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3966178">PMC3966178</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/24672418">Pubmed</a>

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