Verstandig A G, Klin B, Bloom R A, Hadas I, Libson E
Department of Radiology, Hadassah University Hospital, Ein Kerem, Jerusalem.
Radiology. 1989 Sep;172(3):705-7. doi: 10.1148/radiology.172.3.2772176.
The authors reviewed the radiographic findings in 19 patients with phytobezoars of the small bowel. The most common predisposing causes were previous gastric outlet surgery and persimmon ingestion. Twelve patients underwent contrast material-enhanced studies of the upper gastrointestinal tract, and one patient underwent a barium enema study. These examinations revealed four gastric, two duodenal, and eight small bowel phytobezoars in 10 patients. The obstruction caused by small bowel phytobezoars frequently occurred in the jejunum or proximal ileum, more proximally than has been reported in previous series. Barium studies are useful in differentiating obstruction due to postoperative adhesions from obstruction caused by bezoars. In addition, barium studies enable the detection of residual gastric bezoars. This information has important implications in patient treatment because bezoar obstruction is unlikely to respond to conservative treatment, and concurrent gastric bezoars must be removed to prevent recurrent bowel obstruction.
作者回顾了19例小肠植物粪石患者的影像学表现。最常见的诱发原因是既往胃出口手术和食用柿子。12例患者接受了上消化道造影剂增强检查，1例患者接受了钡灌肠检查。这些检查在10例患者中发现了4例胃、2例十二指肠和8例小肠植物粪石。小肠植物粪石引起的梗阻常发生在空肠或回肠近端，比以往系列报道的位置更靠近近端。钡剂检查有助于鉴别术后粘连引起的梗阻和粪石引起的梗阻。此外，钡剂检查能够检测出残留的胃粪石。这些信息对患者治疗具有重要意义，因为粪石梗阻不太可能对保守治疗产生反应，必须清除并存的胃粪石以防止复发性肠梗阻。
