Laparoscopic Treatment of Gastric Phytobezoar

Bezoars are accumulations of foreign mate¬rial within the gastrointestinal tract. They most often occur in the stomach, but they may also be found in the small and large intestine. The commonest type of bezoar is the phytobezoar, which is composed of undi¬gested food material. These usually develop in patients who have undergone gastrointes¬tinal surgery or who have impaired gastric motility. There are several ways to remove a bezoar. Medical therapy, with or without endoscopy, surgical removal, and with the development of laparo-scopic surgery, new options for treatment are available. We report here the case of the laparoscopic treatment of gastric bezoar. A patient presented to the hospital with symptoms of gastric obstruction with nausea, vomiting and abdominal pain. Endoscopy revealed a large gastric bezoar, 11 centimeters in diametar localized in antrum with decubital ulceration of the mucosa, but endoscopic extraction was unsuceessful. Therefore the patient underwent a linear laparoscopic gastrotomy and the bezoar was removed with the use of an endobag. Gastrotomy was closed using intracorporeal suturing. There were no intra and postopera¬tive complications. This case demonstrates that laparoscopic extraction of a phytobezoar as an alternative to laparotomy in patients whose disease is not amenable to endoscopic resolution.