Verklumpung aus verschluckten unverdaulichen Materialien

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Trichobezoar im Magen: 3 Bilder aus der Kontrastmittel-Schluckuntersuchung und Sonografie.
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Trichobezoar:
Case report. Coronal CT section through abdomen shows mottled lucency mass in dialated duodenum.
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Trichobezoar:
Case report. CT abdomen axial sections showing some soft tissue densities in the stomach and duodenum which was partially adherent to the stomach and bowel wall.
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Rapunzel
syndrome: radiographic and ultrasonographic findings. Metallic foreign bodies and multiple air bubbles can be seen in the periumbilical area. There is also a metallic body along with some fluid-fluid levels superimposed in the pelvis.
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Rapunzel
syndrome: radiographic and ultrasonographic findings. A large filling defect can be seen inside the barium-filled stomach. A mottled appearance characterizes the defect.
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Rapunzel
syndrome: radiographic and ultrasonographic findings. Long axis ultrasonographic view in left oblique position demonstrating the water-filled stomach anterior to the pancreas. The mass can be seen displaced to the fundus.
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Small bowel
obstruction due to bezoar: a rare cause. Abdominal X-ray: Dilated small bowel loops with air-fluid levels (red arrows).
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Small bowel
obstruction due to bezoar: a rare cause. Contrast-enhanced CT of abdomen, coronal sections: before the transition point (red arrow) an intraluminal mass with some soft tissue densities and internal air lucencies (green arrow) is seen.
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Small bowel
obstruction due to bezoar: a rare cause. Contrast-enhanced CT of abdomen, axial section: Dilated small bowel loops with an intraluminal mass with some soft tissue densities and internal air lucencies which suggests the existence of a bezoar (red arrow).
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School ager
with protein calorie malnutrition who has just rapidly eaten the equivalent of 3 large meals. AXR AP taken immediately after ingesting 3 large meals shows an extremely distended stomach along with a moderate amount of stool throughout the colon. An AXR obtained the next day showed the stomach to be completely empty, thus ruling out gastric motility problems.The diagnosis was acute gastric distension from overeating, mimicing a bezoar or gastroparesis.
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Teenager on
an exclusively vegetable-protein-xanthum diet with increasing abdominal distension and vomiting. AXR (left) shows a mottled structure filling the entire width of the upper abdomen. Coronal CT with contrast of the abdomen (middle and right) shows the structure is the stomach distended with particulate material. The patient was given cellulase and an AXR one day later showed the stomach to be empty.The diagnosis was phytobezoar.
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Radiopaedia • CC-by-nc-sa 3.0 • de

Bezoars are accumulations of indigestible contents within the gastrointestinal tract .

Pathology

There are several types depending on the predominant components:

  • trichobezoar: a bezoar formed from hair, this has also been called Rapunzel syndrome when the tail of the trichobezoar extends some distance through the small bowel
  • phytobezoar: composed of indigestible food material (e.g. cellulose) and are frequently reported in patients with impaired digestion and decreased gastric motility
    • diospyrobezoar is a subtype of phytobezoar secondary to the consumption of unripe persimmons
  • pharmacobezoar: (or medication bezoars) mostly undigested tablets or semi-liquid masses of drugs
  • lactobezoar: containing undigested milk curds
    • Associations
    • previous gastric surgery
    • psychiatric illness

    Radiographic features

    They are known to cause small bowel obstruction and sometimes CT may demonstrate the bezoar as a mass in the obstructed segment of bowel. The bezoar may be outlined by fluid in the proximally dilated small bowel, and the mass may be mottled owing to air trapped within it.

    History and etymology

    Premodern medicine considered bezoars a special kind of stone with antidote properties. Until the 18 century a gold mounted bezoar was included in the crown jewels. Some ancient pharmacopoeias list 'unicorn horns' as an acceptable alternative if a bezoar is not available. In the late 15 century, Eastern porcupine bezoars were considered especially valuable .

    Differential diagnosis

    See also

    Siehe auch:
    und weiter:
    Assoziationen und Differentialdiagnosen zu Bezoar:
    Dünndarmileus
     
    Wikipedia • CC BY-SA 4.0
    Ileus durch
    Bezoar
    Wikipedia • CC BY-SA 3.0
    Trichobezoar
     
    Wikipedia • CC BY-SA 4.0
    Trichobezoar
    in Magen und Duodenum
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