Cecal Vitamin Bezoar Formation Inducing Abdominal Discomfort

Abstract

OBJECTIVE:

To document a case of cecal lecithin-vitamin B₁₂ bezoar formation inducing abdominal discomfort.

DESIGN:

Case study.

SETTING:

500-bed, community teaching hospital

PATIENT:

81-year-old man with a history of multiple abdominal surgeries who presented with a chief complaint of abdominal pain. Flat plate X-ray of the abdomen revealed multiple capsule-shaped objects lodged in the cecum.

INTERVENTIONS:

Catharsis with bisacodyl, magnesium citrate, NaCl 0.9%; dissolution with heated, dilute barium administered rectally in conjunction with external manipulation; laparotomy.

MAIN OUTCOME MEASURES:

None planned; dissolution or transit of bezoar through gastrointestinal tract desired outcome.

RESULTS/DISCUSSION:

Classification of bezoars and treatment discussed in relation to this case report.

CONCLUSIONS:

Medicinal agents have been implicated in bezoar formation. Treatment options have included: cathartics, heated solvent enemas, and external manipulation and surgery.