Shrivastava Rajesh Kumar Parshuram, Shrivastava Abhishek
Department of Surgery, Shreeji Hospital, Bhilad - Sanjan Road, Daheli-Bhilad, Taluka-Umargaon, Valsad, Gujarat 396105, India.
Nalanda Medical College and Hospital, Patna, Bihar, India.
Int J Surg Case Rep. 2024 Sep;122:110075. doi: 10.1016/j.ijscr.2024.110075. Epub 2024 Jul 24.
Gastric outlet obstruction (GOO) is a rare but serious condition that can arise from various etiologies, including foreign body ingestion. We present a unique case of GOO in a 14-year-old girl resulting from the accumulation of plastic materials, known as a plastic bezoar, due to pica behavior.
A 14-year-old girl with a history of pica presented with symptoms suggestive of acute gastric obstruction. Imaging studies revealed the presence of a large foreign body extending from the stomach to the jejunum, consistent with a plastic bezoar. Despite attempts at endoscopic removal, surgical intervention was ultimately required due to the size and location of the bezoar.
This case underscores the challenges associated with diagnosing and managing gastric outlet obstruction secondary to plastic bezoar formation, particularly in pediatric patients with underlying pica behavior. The diagnostic workup involved a multidisciplinary approach, including imaging studies and endoscopic evaluation. Surgical intervention, although invasive, proved necessary for definitive treatment in this case. Postoperative care focused on monitoring for complications and addressing the underlying pica behavior through psychological intervention and support.
This case highlights the importance of early recognition, thorough diagnostic evaluation, and prompt intervention to prevent complications and ensure favorable outcomes. Collaborative efforts between medical and surgical teams are essential for the comprehensive management of such cases, emphasizing the need for tailored approaches to address both the physical and psychological aspects of care.
胃出口梗阻（GOO）是一种罕见但严重的病症，可由多种病因引起，包括异物摄入。我们报告一例独特的胃出口梗阻病例，发生在一名14岁女孩身上，病因是由于异食癖行为导致塑料物质堆积形成了胃石，即塑料胃石。
一名有异食癖病史的14岁女孩出现提示急性胃梗阻的症状。影像学检查显示有一个从胃延伸至空肠的大异物，符合塑料胃石的表现。尽管尝试了内镜下取出，但由于胃石的大小和位置，最终仍需要手术干预。
该病例强调了诊断和处理继发于塑料胃石形成的胃出口梗阻所面临的挑战，尤其是在有潜在异食癖行为的儿科患者中。诊断检查采用了多学科方法，包括影像学检查和内镜评估。手术干预虽然具有侵入性，但在本病例中被证明是确定性治疗所必需的。术后护理重点是监测并发症，并通过心理干预和支持来解决潜在的异食癖行为。
本病例突出了早期识别、全面诊断评估和及时干预以预防并发症并确保良好结局的重要性。医疗和外科团队之间的协作努力对于此类病例的综合管理至关重要，强调需要采用量身定制的方法来处理护理的身体和心理方面。
