Bezoar로 인한 위장관폐새증 77례의 임상적 고찰

Abstract

This is the report of 77 cases of bezoars associated with gastrointestinal obstruction which were treated surgically from December 1958 to November 1982 at Department of Surgery of Keimyung University School of Medicine in Taegu, Korea. The author has also reviewed and discussed to classification, pathogenesis, clinical symptoms, laboratory studies, diagnosis, complications and treatment of bezoar. 1. The most provalent age group was less than 10 years as 35.1% of all and sex ratio was male preponderance as 2:1. 2. During the six months between August to January, diospyrobezoars are most frequently found in clinical experience. Of the total 77 diospyrobezoars, 61 of them occurred during that six months period. 3. The cardinal symptoms and signs were adbominal pain(29.6%), nausea and vomiting(29.2%), abdominal distention(14.6%) and abdominal mass (11.9%). 4. The previous operative prodecures associated with bezoar formation were gastrectomy due to peptic ulcer (2 cases), adesiolysis due to postoperative adhesion (1 case) and enterotomy due to bezoar (1case). 5. At surgery, 69 patients had gastrointestinal obstruction due to diospyrobezoars and among them two patients had gastric ulcer combined with diospyrobezoars. And three patients had peritionitis due to perforation of the stomach by diospyrobezoars. 6. Of those 69 patients who came to surgery, thirty cases of diospyrobezoars were singly found in the ileum and eleven cases were found in the mutiple locations. But no bezoar was found in one case. 7. Of those 77 cases, one patient refused admission and among the 76 cases admitted to the hospital, four were discharged without operation. And three were treated conservatively. Of those 69 patients who had surgical intervention, sixty seven survived operation and did well postoperatively. Two patients died of postoperative air-way obstruction and sepsis respectively.