NATIONAL PIROGOV MEMORIAL MEDICAL UNIVERSITY, VINNYTSIA, UKRAINE.
Wiad Lek. 2021;74(1):128-131.
The aim: Is to determine the tactics and methods of treatment of bezoars of the gastrointestinal tract.
Materials and methods: From 2001 to 2019, 17 patients were diagnosed with "bezoar".
Results: Due to the "weariness" of the clinic, the diagnosis was made in the first 3 days only for 3 (17,6 %) patients. On the basis of the obtained average pH values for 4 (23,5 %) patients established moderate hypoacid, for 4 (23,5 %) - pronounced hypoacid, for 6 (35,3 %) - anacid. For 5 (29,4 %) patients, the bezoars were withdrawn on the first attempt, while the other 5 (29,4 %) were "lumped". In the course of fibrogastroscopic examination, all patients were diagnosed with impaired motor-evacuation function of the stomach: gastroesophageal and duodenogastric refluxes, presence of passive discharge of the contents of the stomach into the esophagus.
Conclusions: Therefore, the preconditions for the development of bezoars may be: hypo- and anacid, impaired motor-evacuation function of the stomach, chronic gastric ulcer,cognitive impairment. Endoscopic method should be preferred in the treatment, on condition of its failure - laparoscopic gastrotomy with bezoar extraction.
确定治疗胃肠道胃石症的策略和方法。
材料和方法:2001 年至 2019 年,诊断为“胃石症”的 17 例患者。
结果:由于临床的“疲劳”,仅在前 3 天对 3 例(17.6%)患者做出诊断。基于 4 例患者获得的平均 pH 值,确定中度低酸,4 例(23.5%)为明显低酸,6 例(35.3%)为无酸。5 例(29.4%)患者首次尝试即取出胃石,而另 5 例(29.4%)为“结块”。在纤维胃镜检查过程中,所有患者均被诊断为胃动力排空功能受损:胃食管反流和十二指肠胃反流,胃内容物被动排入食管。
因此,胃石形成的前提条件可能为:低酸和无酸、胃动力排空功能受损、慢性胃溃疡、认知障碍。在治疗中应首选内镜方法,如果失败,则采用腹腔镜胃切开术取石。