Lou C C, Lin J N, Wang K L
Department of Surgery, Chang Gung Memorial Hospital, Taipei, Taiwan, R.O.C.
Changgeng Yi Xue Za Zhi. 1990 Sep;13(3):208-13.
Phytobezoars are composed of fruit or vegetable matter, including seeds, nuts, and pits, and are the most common type of bezoar associated with gastrointestinal obstruction. Eleven gastrointestinal phytobezoar in children (less than 15 years old) seen within a period of 8 years (1981-1988) were analysed. Six were boys and 5 were girls. On history, 6 patients developed symptoms after ingestion of persimmon. All cases except one occurred in late fall and winter. In 8 patients, phytobezoar was found in a single location with 5 in the ileum and 3 in the jejunum. Multiple locations were found in 3 patients. Emergency laparotomy was performed on all cases who had typical mechanical intestinal obstruction. Treatment consisted of fragmentation of bezoar with pushing toward the cecum in 9 patients, combined with gastrotomy in 3 patients, and enterotomy in 2 patients. Because the persimmon ingestion is the most common cause of bezoar formation, a careful dietary history will usually suggest the diagnosis preoperatively. All the gastrointestinal tract should be thoroughly examined intraoperatively, especially the stomach and terminal ileum, to prevent another intestinal obstruction caused by an undiscovered phytobezoar.
植物性胃石由水果或蔬菜物质组成，包括种子、坚果和果核，是与胃肠道梗阻相关的最常见的胃石类型。对8年（1981 - 1988年）内收治的11例15岁以下儿童胃肠道植物性胃石进行了分析。其中男孩6例，女孩5例。病史显示，6例患者在食用柿子后出现症状。除1例病例外，所有病例均发生在深秋和冬季。8例患者的胃石位于单一部位，其中5例在回肠，3例在空肠。3例患者的胃石位于多个部位。所有出现典型机械性肠梗阻的病例均进行了急诊剖腹手术。治疗方法包括：9例患者将胃石向盲肠推送使其破碎，3例患者联合胃切开术，2例患者行肠切开术。由于食用柿子是胃石形成的最常见原因，仔细询问饮食史通常可在术前提示诊断。术中应彻底检查整个胃肠道，尤其是胃和回肠末端，以防止未发现的植物性胃石导致再次发生肠梗阻。
