Akın ÖNDER, Murat KAPAN, İbrahim ALİOSMANOĞLU, Çiğdem ALİOSMANOĞLU, Hüseyin TİMUÇİN, Mesut GÜL

Nar çekirdeğine bağlı mekanik kalınbarsak tıkanıklığı

Bezoar sıklıkla zeka geriliği ve psikiyatrik hastalığı olan kişilerde sık görülen, ancak nadiren cerrahi girişim gerektiren bir durumdur. Bezoar yutulan bitkisel ya da hayvansal materyallerin gastrointestinal sistemde birikerek yumak oluşturmasıdır. Sıklıkla midede oluşan bezoarlar ince barsaklara geçerek obstrüksiyona, nadiren de perforasyona sebep olur. Fitobezoar dünyanın her yerinde yaygın olarak karşılaşılan bir durum olup, kalın barsak obstrüksiyonunun nadir sebeplerinden biridir. Bu çalışmamızda yenilen narların çekirdeklerinin birikimine bağlı kolonik tıkanıklık vakası sunulmuştur. On dört yaşındaki çocuk hasta ileusa bağlı akut karın tanısıyla acil servisten yatırılarak ameliyat edildi. Sigmoid kolonda lümeni tam tıkayan fitobezoar tespit edildi. Bezoar çıkarılarak hastaya uç kolostomi uygulandı. Hasta ameliyat sonrası sorunsuz taburcu edildi. Çocuklarda, psikiyatrik hastalarda ve gastrointestinal sistem ameliyatı anamnezi olan barsak tıkanıklığı olgularında bezoarlar akılda tutulmalıdır. Klin Deney Ar Derg 2011; 2 (3): 315-318.

Mechanical colonic obstruction secondary to core of the pomegranate

Bezoars are often common in people with mental retardation and psychiatric disease, a condition that requires surgical intervention. Bezoar is retained concretions of ingested plant or animal materials that accumulate within the gastrointestinal tract. They often form in the stomach and can pass into the small intestine and cause obstruction, rarely leads to perforation. Fitobezoar phenomenon is common all over the world, is one of a rare cause of large bowel obstruction. In this study we report a case of colonic obstruction due to accumulation of edible pomegranates seeds. Fourteen-year-old boy admitted with diagnosis of acute abdomen dependind on ileus to the emergency department were operated. Fytobezoar fully obstructing the lumen of the sigmoid colon was found. Bezoar removed and end colostomy was performed. The patient was discharged after surgery without complication. In children, psychiatric patients, and patients with a history of gastrointestinal surgery in cases of intestinal obstruction differential diagnosis should include bezoars. J Clin Exp Invest 2011; 2 (3): 315-318.

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1. Lee JL, Jung SE. Small-bowel obstruction caused by phytobezoar: MR imaging findings. AJR 2002; 179(4): 538-539.
2. Rubina M, Shimonova M, Griefa F, Rotesteinb Z, Lelcuka S. Phytobezoar: A rare cause of intestinal obstruction. Dig Surg 1998; 15(1): 52-54.
3. Bending DW, Mackie GG. Management of smooth-blunt gastric foreign bodies in asymptomatic patients. Clin Pediatr 1990; 29(5): 642-5.
4. Delabrousse E, Brunelle S, Saguet O, et al. Small bowel obstruction secondary to phytobezoar CT Findings. Clin Imaging 2001; 25(1): 44-6.
5. Whitson BA, Asolati M, Kandaswamy R, Sutherland DE. Diabetic gastroparesis associated bezoar resolution via “colalysis” Clin Transplant. 2008; 22: 242-4.
6. Kellam LL, Johnson PJ, Kramer J, Keegan KG. Gastric impaction and obstruction of the small intestine associated with per simmon phytobezoar in a horse. J Am Vet Med Assoc 2000; 216(11): 1279-81.
7. Park JH, Park CH, Park JH, et al. Review of 209 cases of foreign bodies in the upper gastrointestinal tract and clinical factors for successful endoscopic removal. Korean J Gastroenterol 2004;43(3):226-33.
8. Velitchkov NG, Grigorov GI, Losanoff JE, Kjossev KT. Ingested foreign bodies of the gastrointestinaltract: retrospective analysis of 542 cases. World J Surg 1996;20(11):1001-5.