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上消化道内镜中的胃石:单中心经验。

Bezoar in upper gastrointestinal endoscopy: A single center experience.

机构信息

Department of Gastroenterology, Yüksek İhtisas Training and Research Hospital, Ankara, Turkey.

Department of Gastroenterology, Ahi Evran University Training and Research Hospital, Kırşehir, Turkey.

出版信息

Turk J Gastroenterol. 2020 Feb;31(2):85-90. doi: 10.5152/tjg.2020.18890.

Abstract

BACKGROUND/AIMS: We aimed to investigate the association of bezoar with endoscopic findings, risk factors for bezoar occurrence, and the success of endoscopic treatment in a tertiary center.

MATERIALS AND METHODS

This retrospective study was conducted between January 2012 and December 2015. Overall, 8200 endoscopy records were examined and 66 patients with bezoar were included in the study.

RESULTS

We enrolled 29 (44%) female and 37 (56%) male patients in this study. The mean age of the patients was 63±9.4 years. The most frequent risk factors were history of gastrointestinal surgery (23%), diabetes mellitus (17%), trichophagia (9%), and anxiety disorder (6%). Gastric ulcer, duodenal ulcer, erosive gastritis, and reflux esophagitis were present in 27%, 11%, 20%, and 23% of the patients, respectively. While bezoars were most commonly observed in the stomach (70%), the majority of them were phytobezoars (91%). The mean number of interventions for each patient was 1.5 (range, 1-6). Endoscopy was successful in removing bezoars in 86.5% of the patients. Among those referred to surgery, seven patients underwent gastrostomy (10.5%); one (1.5%) patient underwent gastroenterostomy because of concomitant pyloric stenosis; and one (1.5%) patient underwent fistula repair surgery due to the development of duodenal fistula caused by bezoar.

CONCLUSION

The findings of this study indicated that bezoars are more common among subjects with history of gastrointestinal surgery, diabetes mellitus, or psychiatric disorders; bezoars are closely related to peptic ulcer and reflux esophagitis; and they can be successfully treated with endoscopy.

摘要

背景/目的:我们旨在调查三级中心中胃石与内镜发现、胃石发生的危险因素以及内镜治疗成功率之间的关系。

材料和方法

本回顾性研究于 2012 年 1 月至 2015 年 12 月进行。共检查了 8200 例内镜记录,纳入了 66 例胃石患者进行研究。

结果

本研究纳入了 29 例(44%)女性和 37 例(56%)男性患者。患者的平均年龄为 63±9.4 岁。最常见的危险因素包括胃肠道手术史(23%)、糖尿病(17%)、异食癖(9%)和焦虑障碍(6%)。27%的患者存在胃溃疡,11%存在十二指肠溃疡,20%存在糜烂性胃炎,23%存在反流性食管炎。胃石最常发生于胃(70%),其中大多数为植物性胃石(91%)。每位患者的平均干预次数为 1.5 次(范围为 1-6 次)。内镜成功取出胃石的患者占 86.5%。转外科治疗的患者中,7 例行胃造口术(10.5%);1 例行胃肠吻合术(1.5%),因合并幽门狭窄;1 例行瘘管修复术(1.5%),因胃石导致十二指肠瘘。

结论

本研究结果表明,胃石在有胃肠道手术史、糖尿病或精神疾病病史的患者中更为常见;胃石与消化性溃疡和反流性食管炎密切相关;内镜治疗可有效治疗胃石。

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