Abstract:

Introduction: Acute mechanic intestinal obstruction is one of the common cause of acute abdomen. Its diagnosis is relatively easy. Yet, sometimes recognize the main cause of intestinal obstruction couldn’t be possible proeoperatively. Rate of intestinal obstruction due to bezoars is up to 4%. Obstructive bezoars needs usually surgical interventions.Method: Data of patients who admitted to emergency room with intestinal obstructions between 2011–2016 were evaluated retrospectively. Demographic data, comorbidities and clinic prognosis of patients with ileus due to bezoars were investigated. Asymptomatic and/or elective patients were excluded from study. Results: Eleven male (64.7%), six female (35.3%); 17 patients were included to the study. Mean patient’s age was 56.82±16.97 (17-82) years. In six patients (35.3%) additionnal pathologies were identified and most common comorbidities were diabetes (17.6%) and dementia (11.8%). Computed tomography was performed in 15 patients (88.2%) presurgically. In 12 patients (80%) who underwent tomography, gastrointestinal bezoars which were being responsible from intestinal obstruction were detected. In five patients (29.5%) definitive diagnosis were odtained during surgery. Eleven patients undewent bezoar extirpation with enterotomy. In one patient, totally laparoscopic enterotomy was performed. Bezoar was milked to the colon in a patient. Bezoars were located in stomach in two patients; gastrotomy were performed. In an elderly patient, there were gastric and ileal synchronous bezoars; patient underwent Roux-Y gastrojejunostomy. Fifteen of bezoars (88.2%) were originated from undigested fibers. Main reason of bezoars were tricophagy in two patients (11.8%). Median length of hospital stay was found 4 days (2-11). In only one patient superficial surgical site infection was occured. Conclusion: It’s not quite easy to diagnose presurgically acute intestinal obstruction due to bezoars in consequence of lack of specific clinical and radiologic findings. Knowing the main reason of intestinal obstruction in such patients allows the surgeon to plan more accurate approaches.

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