Intragastric Gallstone-Induced Bezoar: An Unusual Cause of Acute Gastric Outlet Obstruction

George M. Tadros, MD, John M. Draganescu, MD, Leon E. Clarke, MD, M. Anthony Albornoz, MD

Disclosures

South Med J. 2002;95(2) 

In This Article

Abstract and Introduction

Bezoars are an uncommon cause of acute gastric outlet obstruction. To our knowledge, this is the first report of a bezoar formed around a gallstone that migrated to the stomach via a cholecystogastric fistula. Our patient was a 42-year-old African American woman with long-standing type 2 diabetes. We suspect that diabetic diathesis was the major factor responsible for producing the pathologic derangement of the gallbladder and stomach, which led to development of the bezoar and serious complications.

Intragastric foreign bodies are an unusual cause of gastric outlet obstruction. Most cases are due to bezoar formation, defined as the accumulation of either organic or nonorganic material into masses or concretions that are not cleared from the stomach. While clinical manifestations of bezoars vary, they are predominantly represented by gastrointestinal symptoms, and most commonly include nausea, vomiting, and abdominal pain. Although uncommon, fatalities have been reported.[1]

We believe ours is the first report of acute gastric outlet obstruction caused by a large gallstone-induced bezoar that migrated to the stomach via a cholecystogastric fistula (CGF).

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