Gastrointestinal bezoar: Systematic literature review

Abstract

Introduction: A bezoar is a concretion of foreign material or foreign bodies that forms in the lumen of the gastrointestinal tract, usually from the accumulation of non-digestible foreign bodies. It usually forms in the stomach, can pass into the small intestine (Rapunzel syndrome) and is a rare cause of intestinal obstruction. The bezoar is secondary to several causes, such as: alterations in gastric emptying, previous gastric surgeries, excess of high-fiber foods, poor chewing, ingestion of solid materials difficult to digest, alterations in intestinal motility, among others. Most of the patients presenting this alteration are asymptomatic; however, there may be complications related to accumulation of foreign bodies over time, producing symptoms associated with obstruction of the digestive tract, ranging from partial occlusion to total occlusion. There is no specific treatment for bezoars; initially, endoscopic extraction will be attempted, whenever feasible, together with other clinical options, but also the surgical approach becomes an option when the previous therapeutic methods fail.

Objective: To perform an exhaustive bibliographic review of gastrointestinal bezoars, based on current scientific evidence. Methodology: A bibliographic search was carried out in the following electronic databases: Redalyc, Scielo, Scopus, PubMed, Cochrane Library, Google Scholar, among others, which were evaluated on the basis of the feasibility, quality, clarity, pertinence and veracity of the information inherent to the subject; as well as the current relevance of its scientific content. Indexed articles published in the last 12 years in English, Spanish and Portuguese were selected.

Results: 44 articles (100%) were extracted and selected from indexed journals. Review articles, systematic literature review and clinical case reports were included.

Conclusions: Gastrointestinal bezoars are accumulations of non-digestible material in the gastrointestinal tract, which form a solid mass that impedes the passage of the alimentary bolus, ingested intentionally or accidentally. Early diagnosis, adequate and timely management, are essential for a better survival and prognosis in patients