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Case Report
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| Giant gastric lithobezoar in an adult: A case report | ||||||
| Alana Costa Borges1, Marco Augusto Sobreira Rocha Filho2, Vitor de Vasconcelos Muniz2 | ||||||
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1MD, Chief of Department of Gastrointestinal Endoscopy, Military General Hospital of Fortaleza, Fortaleza, Ceará, Brazil.
2MD, Staff physician, Department of General Surgery of the Military General Hospital of Fortaleza, Fortaleza, Ceará, Brazil. | ||||||
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| How to cite this article |
| Borges AC, Rocha Filho MAS, Muniz VV. Giant gastric lithobezoar in an adult: A case report. Int J Case Rep Images 2016;7(7):441–444. |
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Abstract
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Introduction:
A bezoar is a conglomeration of partially digested or undigestible foreign material in the gastrointestinal tract, classified according to its composition. Inorganic matter bezoars are very rare, especially lithobezoars, i.e., stone-composed, in the upper digestive system.
Case Report: A case of 49-year-old male, schizophrenic patient, with a prior history of pica presenting with non-specific symptoms and a 10-kg weight loss. Upon physical examination, an enormous palpable left mass was noted and when mobilized, it produced a peculiar sound. Diagnostic workup comprised exclusively plain radiographs, with pathognomonic findings and subsequent indication of surgery. Exploratory laparotomy revealed a 3.5-kg gastric bezoar encompassing diverse objects, but predominantly stones. There was no evidence of their presence in other organs and no complications. The patient had uneventful recovery and is currently engaged in outpatient follow-up. Conclusion: Pica with resulting bezoar should be suspected in psychiatric adult patients with non-specific symptoms. Giant upper gastrointestinal lithobezoars are very rare and may produce a gastric "crunch sign" on physical examination, which is a clue for the correct diagnosis. Open surgery is effective and can be the treatment of choice. | |
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Keywords:
Bezoar, Crunch sign, Gastric, Lithobezoar, Mass, Pica
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Author Contributions
Alana Costa Borges – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published Marco Augusto Sobreira Rocha Filho – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published Vitor de Vasconcelos Muniz – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published |
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Guarantor of submission
The corresponding author is the guarantor of submission. |
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Source of support
None |
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Conflict of interest
Authors declare no conflict of interest. |
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Copyright
© 2016 Alana Costa Borges et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information. |
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