Taylor J R, Streetman D S, Castle S S
Department of Pharmacy Practice, University of Florida, Gainesville, USA.
Ann Pharmacother. 1998 Sep;32(9):940-6. doi: 10.1345/aph.17420.
To describe a case of a medication bezoar and to review the clinical presentation, diagnosis, risk factors, pathogenesis, complications, and treatment of medication bezoars.
A MEDLINE search (January 1966-December 1997) of the English-language literature pertaining to bezoars was performed. These articles were scanned, and literature specifically discussing medication bezoars was selected. Additionally, the reference sections of pertinent review and case reports were scanned for additional relevant literature.
Bezoars are concretions of foreign material within the body. In the case of medication bezoars, these concretions occur within the digestive tract and are composed of medications and/or medication vehicles. Rarely, however, is bezoar formation solely due to a medication. In nearly all reported cases the patient had one or more significant risk factors that contributed to bezoar formation. The exact method by which medications bezoars form is dependent on the particular type or combination of medications involved. Bezoar formation may be associated with significant complications for the patient due to the presence of the bezoar and because of the effects of the medication within the bezoar. Treatment of medication bezoars depends largely on the location and the cause of the bezoar.
Medication bezoars are a rare but potentially serious complication of medication use in certain patients. These patients often present with signs and symptoms consistent with an obstruction of the gastrointestinal tract and represent an even greater diagnostic challenge due to the rarity of this complication. These patients also face significant complications from both the bezoar and the medication within the bezoar. To date, treatment of medication bezoars involves mainly physical manipulation of the bezoar through lavage, endoscopic removal, or, in most cases, surgical removal.
描述一例药物性胃石症病例，并回顾药物性胃石症的临床表现、诊断、危险因素、发病机制、并发症及治疗。
对1966年1月至1997年12月期间英文文献中有关胃石症的内容进行了医学文献数据库（MEDLINE）检索。对这些文章进行了筛选，并选取了专门讨论药物性胃石症的文献。此外，还查阅了相关综述和病例报告的参考文献部分以获取更多相关文献。
胃石是体内异物的凝结物。对于药物性胃石症，这些凝结物出现在消化道内，由药物和/或药物载体组成。然而，胃石形成很少仅由药物引起。在几乎所有报道的病例中，患者都有一个或多个导致胃石形成的重要危险因素。药物性胃石形成的确切方式取决于所涉及药物的特定类型或组合。由于胃石的存在以及胃石内药物的作用，胃石形成可能会给患者带来严重并发症。药物性胃石症的治疗很大程度上取决于胃石的位置和成因。
药物性胃石症是某些患者用药时罕见但可能严重的并发症。这些患者常表现出与胃肠道梗阻相符的体征和症状，由于这种并发症罕见，诊断面临更大挑战。这些患者还面临来自胃石及胃石内药物的严重并发症。迄今为止，药物性胃石症的治疗主要包括通过洗胃、内镜下取出或在大多数情况下通过手术取出对胃石进行物理处理。
