Vellar D J, Vellar I D, Pucius R, Steedman P K
Aust N Z J Surg. 1986 Aug;56(8):635-8. doi: 10.1111/j.1445-2197.1986.tb04519.x.
Phytobezoar impaction is an important cause of small bowel obstruction in patients who have had previous vagotomy and drainage procedures for duodenal ulcer. Most cases present with typical symptoms and signs of small bowel obstruction, but in some there are no definite radiological signs of bowel obstruction on plain X-ray. In these the phytobezoar is often located by barium studies. Operation is required in the majority of cases and the phytobezoar milked into the large bowel or removed at enterotomy. Before laparotomy is performed, it is essential to endoscope these patients to avoid overlooking gastric phytobezoars which are easily removed via a gastrotomy at the time of the laparotomy. The incidence of phytobezoar obstruction will be reduced by the giving of simple dietary advice and by employing highly selective vagotomy whenever possible in the surgery of duodenal ulcer.
植物性粪石嵌塞是既往因十二指肠溃疡行迷走神经切断术和引流术患者小肠梗阻的重要原因。大多数病例表现为典型的小肠梗阻症状和体征，但有些病例在腹部平片上没有明确的肠梗阻放射学征象。在这些病例中，植物性粪石常通过钡剂检查定位。大多数病例需要手术治疗，将植物性粪石挤入大肠或在肠切开术中取出。在进行剖腹手术前，必须对这些患者进行内镜检查，以避免遗漏胃内植物性粪石，后者在剖腹手术时可通过胃切开术轻松取出。通过提供简单的饮食建议以及在十二指肠溃疡手术中尽可能采用高选择性迷走神经切断术，可降低植物性粪石梗阻的发生率。
