Department of Oncological Surgery with the Subunit of Vascular Surgery, Oncological Centre in Katowice, Katowice, Poland.
Department of General Surgery, District Hospital in Wodzisław Śląski, Wodzisław Śląski, Poland.
BMC Surg. 2020 Nov 12;20(1):281. doi: 10.1186/s12893-020-00945-y.
Bezoars are collections of indigestible material in the gastrointestinal tract, mostly described in children. Polyurethane "plastobezoars" consisting of composites used in the construction industry are rarely described bezoars formed in the esophagus and stomach, causing gastrointestinal obstruction, usually necessitating gastrectomy. We describe an unusual presentation of polyurethane bezoar with a volcanic rock consistency, that caused gastrointestinal obstruction and perforation of the stomach wall.
A 39-year-old man, a construction worker, was referred with signs and symptoms of high gastrointestinal obstruction and abdominal pain. Esophagoscopy revealed a foreign body in the esophagus, 20 cm from the incisor line, causing its obstruction. The attempt to collect the material with forceps failed as the material was too hard. Spiral computed tomography visualized a wide, gas-filled esophagus and a large stomach. The patient with symptoms of acute peritonitis was operated. There were several microperforations of the stomach wall, caused by sharp bezoar fragments that filled the upper one-third of the stomach and lower part of the esophagus. After a longitudinal stomach incision, the bezoar was bluntly dissected from the wall and removed, and the stomach microperforations were closed by wall duplication. After the operation, the patient confessed to drinking, of his own free will, a two-component building foam used to seal pipes. The patient started normal feeding on the 4th day and was discharge home.
Polyurethane bezoars may cause stomach wall perforation and acute peritonitis. Computed tomography has limited usefulness in patients with polyurethane bezoars due to their low specific weight.
胃石是胃肠道中无法消化的物质的集合，主要在儿童中描述。由建筑行业中使用的复合材料组成的聚氨酯“塑胃石”很少被描述为在食管和胃中形成的胃石，导致胃肠道梗阻，通常需要胃切除术。我们描述了一种不常见的表现形式，即具有火山岩稠度的聚氨酯胃石，导致胃肠道梗阻和胃壁穿孔。
一名 39 岁的男性，建筑工人，因有高胃肠道梗阻和腹痛的症状和体征而被转诊。食管镜检查显示，在切牙线 20 厘米处的食管中有一个异物，导致其梗阻。由于材料过硬，用钳子试图收集材料的尝试失败了。螺旋 CT 可视化显示食管呈宽阔充气状态，胃也很大。有症状的急性腹膜炎患者接受了手术。胃壁有几个微小穿孔，是由充满胃上三分之一和食管下段的尖锐胃石碎片引起的。在进行胃纵行切开后，从壁上钝性分离出胃石并将其取出，并通过壁重复闭合胃壁微穿孔。手术后，患者承认自愿饮用了一种用于密封管道的双组分建筑泡沫。患者在第 4 天开始正常进食，并出院回家。
聚氨酯胃石可能导致胃壁穿孔和急性腹膜炎。由于其比重低，计算机断层扫描对聚氨酯胃石患者的用处有限。
