Department of General Surgery, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, Zhejiang, Peoples Republic of China.
J Int Med Res. 2021 Jan;49(1):300060520979377. doi: 10.1177/0300060520979377.
To evaluate the clinical characteristics and indications for surgery for bezoar-induced small bowel obstruction (BI-SBO).
Forty patients with BI-SBO were treated at our hospital from January 2017 to December 2019, and these patients' clinical and computed tomography (CT) data were analyzed.
Twenty-seven and 13 BI-SBO patients constituted the non-ST group and ST group, respectively. The clinical manifestations of BI-SBO in both groups were abdominal pain, nausea, vomiting, and lack of defecation. Comparing the non-ST vs ST groups, respectively: mean age (years): 63.15 ± 16.15 vs 60.38 ± 12.47; duration of symptoms (hours): 55.11 ± 44.08 vs 59.33 ± 72.90; mean bezoar length (cm): 5.31 ± 0.74 vs 3.72 ± 0.53; mean bezoar width (cm): 3.74 ± 0.48 vs 2.9 ± 0.64; bezoar CT maximum Hounsfield units (HU): 97.23 ± 12.36 vs 21.11 ± 7.27; total hospital stay (days): 5.56 ± 4.23 vs 7.12 ± 6.12 (mean: 8.62 ± 2.81); and total hospitalization costs (RMB): 6378.02 ± 3015.68 vs 8213.71 ± 5564.29. Mean operation time was 85.00 ± 8.90 minutes, and mean operation blood loss was 32.31 ± 19.64 mL. Bezoars were located 60 to 160 cm from the ileocecal junction. Univariate analysis demonstrated that bezoar length and width and maximum CT value were significant risk factors for surgery.
Large bezoar size and high CT values may be indications for surgery. Surgery is necessary and effective when nonsurgical treatment is ineffective.
评估胃石性小肠梗阻（BI-SBO）的临床特征和手术适应证。
2017 年 1 月至 2019 年 12 月，我院收治 40 例 BI-SBO 患者，分析其临床和计算机断层扫描（CT）资料。
27 例 BI-SBO 患者为非 ST 组，13 例为 ST 组。两组 BI-SBO 的临床表现均为腹痛、恶心、呕吐、无排便。与非 ST 组相比，ST 组的平均年龄（岁）为 63.15±16.15 比 60.38±12.47；症状持续时间（小时）为 55.11±44.08 比 59.33±72.90；胃石平均长度（cm）为 5.31±0.74 比 3.72±0.53；胃石平均宽度（cm）为 3.74±0.48 比 2.9±0.64；胃石 CT 最大亨氏单位（HU）为 97.23±12.36 比 21.11±7.27；总住院时间（天）为 5.56±4.23 比 7.12±6.12（平均：8.62±2.81）；总住院费用（人民币）为 6378.02±3015.68 比 8213.71±5564.29。平均手术时间为 85.00±8.90 分钟，平均手术出血量为 32.31±19.64mL。胃石位于回盲交界处 60 至 160cm 处。单因素分析表明，胃石的大小和最大 CT 值是手术的显著危险因素。
大的胃石大小和高的 CT 值可能是手术的适应证。当非手术治疗无效时，手术是必要和有效的。
