Bezoar-induced small bowel obstruction: Clinical characteristics and diagnostic value of multi-slice spiral computed tomography

Table 1 Predisposing factors of bezoar-induced small bowel obstruction n (%)

Predisposing factor	Case
Sex
Male	13 (37.1)
Female	22 (62.9)
Age (yr)
< 63	15 (42.9)
≥ 63	20 (57.1)
Symptom
Abdominal pain	23 (65.7)
Abdominal distension	35 (100)
Vomiting	15 (42.9)
Defecation and exhaust stopping	12 (34.3)
Physical sign
Fever	7 (20)
Abdominal protuberance	29 (82.9)
Abdominal tenderness	9 (25.7)
Tenderness and rebound Tenderness	9 (25.7)
Cords	7 (20)
Food intake before the onset
Persimmon, hawthorn, jujube	29 (82.9)
Uncertainty	6 (17.1)
Previous history
Stomach stone or bezoar treatment history	3 (8.6)
Gastroduodenal operation history	19 (54.3)
Other history of abdominal operation	6 (8.6)
Dental status
Teeth sound (partial denture)	9 (25.7)
Partial or total loss of posterior teeth	26 (74.3)

Table 2 Impaction sites, concomitant bezoars and computed tomography diagnosis

Impaction site(n = 35)	Concomitant site	Case, n	CT confirmed, n
			Impaction bezoars	Concomitant bezoars
Duodenum	No	1	1	0
Jejunum	No	6	6	0
	Stomach	2	2	2
	Ileum	1	1	1
Ileum	No	12	12	0
	Stomach	3	3	1
	Jejunum	3	3	3
	Ileum	7	7	7
Total		35	35	14

CT: Computed tomography.

Table 3 Computed tomography findings of impaction bezoars

Signs		Case	Percentage
Impaction bezoars		35
Well delineated mass in the intestinal lumen, with a mixed density and containing air	With encapsulating wall	6	17.1
	Without encapsulating wall	29	82.9
Bowel and perienteric changes
Bowel wall thickening	Obstruction and proximal	34	97.1
	With distal to the obstruction	11	31.4
Lumen dilatation proximal to the obstruction		34	97.1
Intestinal infarction		0	0
Mesenteric haziness		32	91.4
Ascites		13	37.1
CTA changes		17
Mesenteric vascular engorgement	Obstruction and proximal	17	100
	With distal to the obstruction	7	41.2