- 期刊
Clinical Spectrum and Treatment of Bezoars in Adults: Experience of 20 Cases in a Single Institute
成人腸胃道結石的臨床特性與治療：單一醫院20位病例的經驗
摘要
目的 腸胃道結石是少見因攝食不易消化的物質所造成的結果。本篇報告統計分析三軍總醫院20位診斷為腸胃道結石的成人病患，並探討其臨床特性、診斷方式與治療方法。 方法 我們從十六年的病歷資料庫中搜尋出三十七位診斷為腸胃道結石的病患。其中二十位病患是年滿十八歲的成人病患。我們統計這二十病患的年齡、性別、臨床徵候、影像特性、結石位置、治療方式及手術情形，然後做進一步的分析與討論。 結果 這二十位病患中，七位有曾經接受腹部手術的病史。十九位病患是纖維結石，另一位則是毛髮結石。在大多數的病患（十七位），腸胃道結石只發生在一處；另有兩位病人有二處；而其餘一位病患則有三處發現有腸胃道結石。此外，大多數的病患（十六位），腸胃道結石只有一個，包括一位毛髮結石；其餘四位病患則有兩個以上的結石。十五位病患接受手術治療，而其餘五位病患則接受內視鏡治療。在十五位病患接受手術治療中，有兩位有術後腹部傷口感染的情況。 結論 成人腸胃道結石雖然少見，卻是造成腸阻塞必須排除的原因之一。我們統計本院十六年，計二十位病患的病歷資料，藉由分析此資料讓我們能夠進一步了解成人腸胃道結石的臨床特性及徵候，以利早期診斷及治療。
並列摘要
Purpose. Bezoars within the intestinal tract are the uncommon result of ingestion of poorly digestible or indigestible substances. The purpose of this study was to analyze the 20 cases' experience of adult gastrointestinal bezoars in our hospital and to assess their clinical entity, diagnostic methods, and treatment strategies. Methods. After searching the medical database of our institute, records of all patients with the discharge diagnosis of bezoars, including phytobezoars and trichobezoars of the gut, were collected and evaluated. Results. Nineteen patients had phytobezoars and one patient was diagnosed as having a trichobezoar. In most (17 of 20) patients, bezoars were found in only one site, two patients had bezoars in two sites and one in three sites. Most patients (16 of 20) had a single bezoar, including the one patient with trichobezoar, and the other four patients (20%) had more than two bezoars. Seven patients (35%) had previous abdominal operations. Five patients were treated endoscopically and 15 patients were treated surgically. Two postoperative complications with abdominal wound infection were noted. Conclusions. Bezoars are increasingly recognized as a cause of intestinal obstruction. A thorough understanding of bezoars can allow clinicians to be especially alert when dealing with patients showing signs of intestinal obstruction, allowing diagnosis of such a condition at an early stage, followed by appropriate treatment.