Login Register Cart 0
Generic placeholder image

Current Drug Research Reviews

Editor-in-Chief

ISSN (Print): 2589-9775
ISSN (Online): 2589-9783

Back
Journal Home About Journal Editorial Board Current Issue Volumes/Issues
Subscribe
Review Article

Clinical and Forensic Aspects of Pharmacobezoars

Author(s): Francisco Basílio* and Ricardo Jorge Dinis-Oliveira*

Volume 12, Issue 2, 2020

Page: [118 - 130] Pages: 13

DOI: 10.2174/2589977512666200217094018

Price: $65

Open Access Journals Promotions 2
conference banner
Abstract

Background: Pharmacobezoars are specific types of bezoars formed when medicines, such as tablets, suspensions, and/or drug delivery systems, aggregate and may cause death by occluding airways with tenacious material or by eluting drugs resulting in toxic or lethal blood concentrations.

Objective: This work aims to fully review the state-of-the-art regarding pathophysiology, diagnosis, treatment, and other relevant clinical and forensic features of pharmacobezoars.

Results: Patients of a wide range of ages and of both sexes present with signs and symptoms of intoxications or more commonly gastrointestinal obstructions. The exact mechanisms of pharmacobezoar formation are unknown but are likely multifactorial. The diagnosis and treatment depend on the gastrointestinal segment affected and should be personalized to the medication and the underlying factor. A good and complete history, physical examination, image tests, upper endoscopy, and surgery through laparotomy of the lower tract are useful for diagnosis and treatment.

Conclusion: Pharmacobezoars are rarely seen in clinical and forensic practice. They are related to controlled or immediate-release formulations, liquid, or non-digestible substances, in normal or altered digestive motility/anatomy tract, and in overdoses or therapeutic doses, and should be suspected in the presence of risk factors or patients taking drugs which may form pharmacobezoars.

Keywords: Pharmacobezoar, pathophysiology, signs and symptoms, clinical and forensic diagnosis, treatment, laparotomy.

« Previous Next »
Graphical Abstract

[1]
Williams RS. The fascinating history of bezoars. Med J Aust 1986; 145(11-12): 613-4.
[http://dx.doi.org/10.5694/j.1326-5377.1986.tb139511.x] [PMID: 3540541]
[2]
Paschos KA, Chatzigeorgiadis A. Pathophysiological and clinical aspects of the diagnosis and treatment of bezoars. Ann Gastroenterol 2019; 32(3): 224-32.
[http://dx.doi.org/10.20524/aog.2019.0370] [PMID: 31040619]
[3]
Iwamuro M, Okada H, Matsueda K, et al. Review of the diagnosis and management of gastrointestinal bezoars. World J Gastrointest Endosc 2015 Apr 16; 7(4): 336-45.
[http://dx.doi.org/10.4253/wjge.v7.i4.336] [PMID: 25901212]
[4]
Yelisetti R, Awad A, Ambreen B, Zijoo R, Wallach S. Pharmacobezoar: An unusual cause of large bowel obstruction gastroenterol Res 2017; 10(5): 315-7.
[http://dx.doi.org/10.14740/gr871w] [PMID: 29118874]
[5]
Ripollés T, García-Aguayo J, Martínez MJ, Gil P. Gastrointestinal bezoars: sonographic and CT characteristics. Rev Med Chil 2016; 144(8): 1073-7.
[PMID: 27905655]
[6]
Degheili JA, Sebaaly MG, Hallal AH. Nasogastric Tube Feeding-Induced Esophageal Bezoar: Case Description. Case Rep Med 2017.20171365736
[http://dx.doi.org/10.1155/2017/1365736] [PMID: 28479919]
[7]
England G, Heath KJ, Gilbert JD, Byard RW. Forensic features of pharmacobezoars. J Forensic Sci 2015; 60(2): 341-5.
[http://dx.doi.org/10.1111/1556-4029.12679] [PMID: 25537433]
[8]
Simpson SE. Pharmacobezoars described and demystified. Clin Toxicol (Phila) 2011; 49(2): 72-89.
[http://dx.doi.org/10.3109/15563650.2011.559472] [PMID: 21370943]
[9]
Taylor JR, Streetman DS, Castle SS. Medication bezoars: a literature review and report of a case. Ann Pharmacother 1998 Sep; 32(9): 940-6.
[http://dx.doi.org/10.1345/aph.17420] [PMID: 9762382]
[10]
Von düring S, Challet C, Christin C. Endoscopic removal of a gastric pharmacobezoar induced by clomipramine, lorazepam, and domperidone overdose: A case report. J Med Case Reports 2019; 13(1): 45.
[http://dx.doi.org/10.1186/s13256-019-1984-0] [PMID: 30808405]
[11]
Labarinas S, Meulmester K, Greene S, Thomas J, Virk M, Erkonen G. Extracorporeal cardiopulmonary resuscitation after diphenhydramine ingestion. J Med Toxicol 2018; 14(3): 253-6.
[http://dx.doi.org/10.1007/s13181-018-0672-6] [PMID: 29956117]
[12]
Rauber-Lüthy C, Hofer KE, Bodmer M, Kullak-Ublick GA, Kupferschmidt H, Ceschi A. Gastric pharmacobezoars in quetiapine extended-release overdose: A case series. Clin Toxicol (Phila) 2013; 51(10): 937-40.
[http://dx.doi.org/10.3109/15563650.2013.856442] [PMID: 24199644]
[13]
Tatekawa Y, Nakatani K, Ishii H, Paku S, Kasamatsu M, Sekiya N, et al. Small bowel obstruction caused by a medication bezoar: report of a case. Surg Today 1996; 26(1): 68-70.
[http://dx.doi.org/10.1007/BF00311997] [PMID: 8680127]
[14]
Niezabitowski LM, Nguyen BN, Gums JG. Extended-release nifedipine bezoar identified one year after discontinuation. Ann Pharmacother 2000; 34(7-8): 862-4.
[http://dx.doi.org/10.1345/aph.19112] [PMID: 10928396]
[15]
Wells CD, Luckritz TC, Rady MY, Zornik JM, Leighton JA, Patel BM. Bezoar formation requiring endoscopic removal after intentional overdose of extended-release nifedipine. Pharmacotherapy 2006; 26(12): 1802-5.
[http://dx.doi.org/10.1592/phco.26.12.1802] [PMID: 17125441]
[16]
Lung D, Cuevas C, Zaid U, Ancock B. Venlafaxine pharmacobezoar causing intestinal ischemia requiring emergent hemicolectomy. J Med Toxicol 2011; 7(3): 232-5.
[http://dx.doi.org/10.1007/s13181-011-0144-8] [PMID: 21373970]
[17]
Briggs AL, Deal LL. Endoscopic removal of pharmacobezoar in case of intentional potassium overdose. J Emerg Med 2014; 46(3): 351-4.
[http://dx.doi.org/10.1016/j.jemermed.2013.08.031] [PMID: 24113476]
[18]
Hoegberg LCG, Refsgaard F, Pedersen SH, Personne M, Ullah S, Panagiotidis G, et al. Potential pharmacobezoar formation of large size extended-release tablets and their dissolution - an in vitro study Clin Toxicol (Phila) 2019; 04; 57(4): 271-81.
[http://dx.doi.org/10.1080/15563650.2018.1513138] [PMID: 30306811]
[19]
Buckley NA, Dawson AH, Reith DA. Controlled release drugs in overdose. Clinical considerations. Drug Saf 1995; 12(1): 73-84.
[http://dx.doi.org/10.2165/00002018-199512010-00006] [PMID: 7741985]
[20]
Prisant LM, Spaulding VC. Antihypertensive pharmacobezoar. J Clin Hypertens (Greenwich) 2006; 8(4): 296-8.
[http://dx.doi.org/10.1111/j.1524-6175.2006.05179.x] [PMID: 16596036]
[21]
Tungaraza TE, Talapan-Manikoth P, Jenkins R. Curse of the ghost pills: the role of oral controlled-release formulations in the passage of empty intact shells in faeces. Two case reports and a literature review relevant to psychiatry. Ther Adv Drug Saf 2013; 4(2): 63-71.
[http://dx.doi.org/10.1177/2042098612474681] [PMID: 25083252]
[22]
Kwon HY, Scott RL, Mulloy JP. Small bowel Procardia XL tablet bezoar mimicking cystic pneumatosis intestinalis. Abdom Imaging 1996; 21(2): 142-4.
[http://dx.doi.org/10.1007/s002619900029] [PMID: 8661759]
[23]
Herrle F, Peters T, Lang C, von Fluee M, Kern B, Peterli R. Bolus obstruction of pouch outlet by a granular bulk laxative after gastric banding. Obes Surg 2004; 14(7): 1022-4.
[http://dx.doi.org/10.1381/0960892041719563] [PMID: 15329197]
[24]
Vanderbeek PB, Fasano C, O’Malley G, Hornstein J. Esophageal obstruction from a hygroscopic pharmacobezoar containing glucomannan. Clin Toxicol (Phila) 2007; 45(1): 80-2.
[http://dx.doi.org/10.1080/15563650601006215] [PMID: 17357389]
[25]
Ginther DN, Kriegler S, Kanthan R, Shaw JM. Unexpected intra-operative diagnosis of a large cystic phaeochromocytoma and secondary nifedipine pharmacobezoar. S Afr J Surg 2012; 50(3): 98-9.
[http://dx.doi.org/10.7196/sajs.1190] [PMID: 22856448]
[26]
Sultania S, Singh Dhandhu B, Bhardwaj H, Nijhawan S. Gastric pharmacobezoar of mesalamine tablets retrieved endoscopically ACG Case Rep J 2017.4e31
[http://dx.doi.org/10.14309/crj.2017.31] [PMID: 28286796]
[27]
Marín Pozo JF, Soriano Martínez M, Caba Porras I, Rodríguez Torné G, Castelo Luque A. [Pharmacobezoar in a patient operated on for pyloric stenosis] Farm Hosp 2004; 28(1): 59-63.
[PMID: 15012180]
[28]
Tavakkoli H. Esophageal pharmacobezoar in a patient with achalasia: a case report. Middle East J Dig Dis 2019; 11(3): 174-6.
[http://dx.doi.org/10.15171/mejdd.2019.145] [PMID: 31687117]
[29]
Smitz S, Bonnet V, Delporte JP. Severe gastrointestinal dysfunction and retention of extended release nifedipine tablets. J Am Geriatr Soc 1998; 46(5): 656-7.
[http://dx.doi.org/10.1111/j.1532-5415.1998.tb01088.x] [PMID: 9588385]
[30]
Kaplan M, Ozeri Y, Agranat A, Brisk R, Eylath U. Antacid bezoar in a premature infant. Am J Perinatol 1995; 12(2): 98-9.
[http://dx.doi.org/10.1055/s-2007-994414] [PMID: 7779206]
[31]
Iwamuro M, Saito S, Yoshioka M, Urata H, Ueda K, Yamamoto K, et al. A Magnesium Oxide Bezoar. Intern Med 2018 Nov 1; 57(21): 3087-91.
[http://dx.doi.org/10.2169/internalmedicine.1124-18] [PMID: 29877289]
[32]
Toni García M, Zugasti Murillo A, Pueyo Royo A, Petrina Jáuregui E. Pharmacobezoar induced by enteral nutrition. Endocrinol Nutr 2011; 58(5): 249-51.
[PMID: 21458393]
[33]
Gandhi S, Arora E, Bhandarwar A, Patil A, Wagh A, Gupta S. When a cure becomes the pathology: mechanical bowel obstruction due to herbal pharmacobezoar. A case report with review of literature. Clin J Gastroenterol 2018; 11(5): 396-400.
[http://dx.doi.org/10.1007/s12328-018-0861-5] [PMID: 29680980]
[34]
Shigekawa Y, Kobayashi Y, Higashiguchi T, et al. Rectal obstruction by a giant pharmacobezoar composed of magnesium oxide: report of a case. Surg Today 2010; 40(10): 972-4.
[http://dx.doi.org/10.1007/s00595-009-4158-7] [PMID: 20872203]
[35]
Kotzampassi K, Grosomanidis V. Pharmacobezoar in an obese patient with intragastric balloon: a case revealed at endoscopy. Clin Obes 2012; 2(5-6): 168-70.
[http://dx.doi.org/10.1111/cob.12003] [PMID: 25586252]
[36]
Li YK, Lam KF, Wong CLW, Wong A. In vitro study of pharmacobezoar formation in simulated acetaminophen overdose. Clin Toxicol (Phila) 2019; 1-7.
[http://dx.doi.org/10.1080/15563650.2019.1705971] [PMID: 31875726]
[37]
Höjer J, Personne M. Endoscopic removal of slow release clomipramine bezoars in two cases of acute poisoning. Clin Toxicol (Phila) 2008; 46(4): 317-9.
[http://dx.doi.org/10.1080/15563650701378738] [PMID: 18363128]
[38]
Yeen WC, Willis IH. Retention of extended release nifedipine capsules in a patient with enteric stricture causing recurrent small bowel obstruction. South Med J 2005; 98(8): 839-42.
[http://dx.doi.org/10.1097/01.smj.0000173085.76821.11] [PMID: 16144187]
[39]
Lubecka A, Szmeja J. A rare cause of gastrointestinal obstruction. Drug poisoning as a surgical disorder? Pol Przegl Chir 2018; 90(1): 55-8.
[http://dx.doi.org/10.5604/01.3001.0011.5967] [PMID: 29513253]
[40]
Abou Azar S, Wehbe MR, Jamali S, Hallal A. Small bowel obstruction secondary to a metamucil bezoar: case report and review of the literature. Case Rep Surg 2017.20172702896
[http://dx.doi.org/10.1155/2017/2702896] [PMID: 29085697]
[41]
Robert R, Frat JP, Veinstein A, Rouffineau J. Protective effect of medication bezoar after a massive beta-blocker, digoxin, and amitriptyline poisoning. Clin Toxicol (Phila) 2005; 43(5): 381-2.
[http://dx.doi.org/10.1081/CLT-200066095] [PMID: 16235513]
[42]
Johnson J, Williams K, Banner W Jr. Adolescent with prolonged toxidrome. Clin Toxicol (Phila) 2017; 55(5): 364-5.
[http://dx.doi.org/10.1080/15563650.2017.1287912] [PMID: 28421841]
[43]
Lurie Y, Bentur Y, Levy Y, Baum E, Krivoy N. Limited efficacy of gastrointestinal decontamination in severe slow-release carbamazepine overdose. Ann Pharmacother 2007; 41(9): 1539-43.
[http://dx.doi.org/10.1345/aph.1K162] [PMID: 17666577]
[44]
Shenvi A. Gaviscon: not always entirely safe Case Reports 2013 Jan 17;
[http://dx.doi.org/10.1136/bcr-2012-007866]
[45]
Jain SA, Agarwal L, Khyalia A, Chandolia P, Kaknale H. Pharmacobezoar-a rare case presented as gastric outlet obstruction. J Surg Case Rep 2018; 5: 116.
[http://dx.doi.org/10.1093/jscr/rjy116] [PMID: 29977510]
[46]
Black T, Philips G, Burbridge R. Pharmacobezoar in a patient on an oral phosphate binder. Gastrointest Endosc 2013; 77(3): 511-2.
[http://dx.doi.org/10.1016/j.gie.2012.11.002] [PMID: 23410703]
[47]
Kaneko H, Tomomasa T, Kubota Y, Todokoro M, Kato M, Miyazawa R, et al. Pharmacobezoar complicating treatment with sodium alginate. J Gastroenterol 2004; 39(1): 69-71.
[http://dx.doi.org/10.1007/s00535-003-1247-z] [PMID: 14767738]
[48]
Vega-Mata N, Fernández-García L, Lara-Cardenas C, Raposo-Rodríguez L, Montes-Granda M. Paediatric pharmacobezoar in vitamin overdose. Cir Cir 2017; 85: 30-3.
[PMID: 28041610]
[49]
Hutter D, Akgun S, Ramamoorthy R, Dever LL. Medication bezoar and esophagitis in a patient with HIV infection receiving combination antiretroviral therapy. Am J Med 2000; 108(8): 684-5.
[http://dx.doi.org/10.1016/S0002-9343(00)00400-9] [PMID: 10896628]
[50]
Mmeje C, Bouchard A, Heppell J. Image of the month. Pharmacobezoar: a rare complication after ileal pouch-anal anastomosis for ulcerative colitis. Clin Gastroenterol Hepatol 2010; 8(6): A28.
[http://dx.doi.org/10.1016/j.cgh.2009.09.034] [PMID: 19835988]
[51]
Mortensen KE, Munkholm J, Dalhoff KP, Hoegberg LC. Oesophageal obstruction from a pharmacobezoar resulting in death. Basic Clin Pharmacol Toxicol 2017; 120(2): 213-6.
[http://dx.doi.org/10.1111/bcpt.12662] [PMID: 27565635]
[52]
Khera G, Lord R, Grey K, Maitra D. An unusual case of right iliac fossa mass-Pharmacobezoar mimicking inflammatory bowel disease. Colorectal Dis 2008; 10(1): 95-6.
[PMID: 18078462]
[53]
O’Malley JA, Ferrucci JT Jr, Goodgame JT Jr. Medication bezoar: intestinal obstruction by an isocal bezoar. Case report and review of the literature. Gastrointest Radiol 1981; 6(2): 141-4.
[http://dx.doi.org/10.1007/BF01890238] [PMID: 6788638]
[54]
Magdalan J, Zawadzki M, Słoka T, Sozański T. Suicidal overdose with relapsing clomipramine concentrations due to a large gastric pharmacobezoar. Forensic Sci Int 2013; 229(1-3): 19-22.
[http://dx.doi.org/10.1016/j.forsciint.2013.03.025] [PMID: 23570967]
[55]
Stack PE, Thomas E. Pharmacobezoar: an evolving new entity. Dig Dis 1995; 13(6): 356-64.
[http://dx.doi.org/10.1159/000171515] [PMID: 8590522]
[56]
Bogacz K, Caldron P. Enteric-coated aspirin bezoar: Elevation of serum salicylate level by barium study. Case report and review of medical management. Am J Med 1987; 83(4): 783-6.
[http://dx.doi.org/10.1016/0002-9343(87)90915-6] [PMID: 2823600]
[57]
Tecklenburg FW, Thomas NJ, Webb SA, Case C, Habib DM. Pediatric ECMO for severe quinidine cardiotoxicity. Pediatr Emerg Care 1997; 13(2): 111-3.
[http://dx.doi.org/10.1097/00006565-199704000-00007] [PMID: 9127419]
[58]
Gavala A, Manou D, Psalida V, Nystatzaki M, Mavrogiannis C, Alevizopoulos G, et al. Methadone Gastrobezoar in a Psychiatric Patient Presented in Coma. Indian J Crit Care Med 2017; 21(11): 796-8.
[http://dx.doi.org/10.4103/ijccm.IJCCM_17_17] [PMID: 29279645]
[59]
Burruss GL, Van Voorst SJ, Crawford AJ, Bhattacharya SK. Small bowel obstruction from an antacid bezoar: a ranitidine-antacid interaction? South Med J 1986; 79(7): 917-8.
[http://dx.doi.org/10.1097/00007611-198607000-00038] [PMID: 3726597]
[60]
Agha FP, Nostrant TT, Fiddian-Green RG. “Giant colonic bezoar:” a medication bezoar due to psyllium seed husks. Am J Gastroenterol 1984; 79(4): 319-21.
[PMID: 6711534]
[61]
Schmit G, De Boosere E, Vanhaebost J, Capron A. Bupropion Overdose Resulted in a Pharmacobezoar in a Fatal Bupropion (Wellbutrin®) Sustained-release Overdose: Postmortem Distribution of Bupropion and its Major Metabolites. J Forensic Sci 2017 Nov; 62(6): 1674-6.
[http://dx.doi.org/10.1111/1556-4029.13497] [PMID: 28631318]
[62]
Morini L, Moretti M, Brandolini F, Osculati AMM, Groppi A, Vignali C. Two Fatal Cases Involving Cardiovascular Drugs Diltiazem and Amlodipine. J Anal Toxicol 2018; 42(1): e15-9.
[http://dx.doi.org/10.1093/jat/bkx087] [PMID: 29140511]
[63]
Silbergleit R, Lee DC. Bowel obstruction and radiopaque vitamin B12 “pseudobezoar”. Am J Emerg Med 1995; 13(1): 112-3.
[http://dx.doi.org/10.1016/0735-6757(95)90277-5] [PMID: 7832937]
[64]
Guillermo PTJ, Carlos PHJ, Ivonne BAM, Herminio TF, Rubén RP. Extended release potassium salts overdose and endoscopic removal of a pharmacobezoar: A case report. Toxicol Rep 2014; 1: 209-13.
[http://dx.doi.org/10.1016/j.toxrep.2014.04.002] [PMID: 28962240]
[65]
Velez LI, Gracia R, Mills LD, Shepherd G, Feng SY. Iron bezoar retained in colon despite 3 days of whole bowel irrigation. J Toxicol Clin Toxicol 2004; 42(5): 653-6.
[http://dx.doi.org/10.1081/CLT-200026974] [PMID: 15462159]
[66]
Menke JA, Stallworth RE, Binstadt DH, Strano AJ, Wallace SE. Medication bezoar in a neonate. Am J Dis Child 1982; 136(1): 72-3.
[PMID: 7055113]
[67]
Attou R, Reper P. Slow-release clomipramine acute poisoning with radio-opaque gastric bezoar. Intensive Care Med 2013; 39(7): 1320.
[http://dx.doi.org/10.1007/s00134-013-2925-9] [PMID: 23620219]
[68]
Akshintala D, Mendez A, Ikladios OI, Emani VK. Severe salicylate poisoning resistant to conventional management. J Community Hosp Intern Med Perspect 2018; 8(6): 373-5.
[http://dx.doi.org/10.1080/20009666.2018.1551027] [PMID: 30559949]
[69]
Liaw GW, Chen CH, Tseng YJ, Zong HD. Pharmacobezoar of the esophagus. Clin Toxicol (Phila) 2011; 49(4): 348-9.
[http://dx.doi.org/10.3109/15563650.2011.565420] [PMID: 21463225]
[70]
Sarma J, Eikermann M. Images in anesthesiology: A large gastric Bezoar: preanesthetic considerations. Anesthesiology 2011; 115(1): 175.
[http://dx.doi.org/10.1097/ALN.0b013e31820b8a29] [PMID: 21694514]
[71]
Landsman I, Bricker JT, Reid BS, Bloss RS. Emergency gastrotomy: treatment of choice for iron bezoar. J Pediatr Surg 1987; 22(2): 184-5.
[http://dx.doi.org/10.1016/S0022-3468(87)80446-3] [PMID: 3820024]
[72]
Sato C, Kamijo Y. An unexpected prolonged coma due to a pharmacobezoar formed from Vegetamine A® tablet ingestion. Acute Med Surg 2014; 2(1): 60-3.
[http://dx.doi.org/10.1002/ams2.58] [PMID: 29123693]
[73]
Endoscopic removal of a pharmacobezoar of slow release theophylline. Br Med J (Clin Res Ed) 1987; 294(6564): 125.
[http://dx.doi.org/10.1136/bmj.294.6564.125-d] [PMID: 3105655]
[74]
Hunt-Fugate AK, Schmidt HJ. Cecal vitamin bezoar formation inducing abdominal discomfort. Ann Pharmacother 1992; 26(4): 485-7.
[http://dx.doi.org/10.1177/106002809202600405] [PMID: 1576383]
[75]
Donnelly K, Walkowiak HB, Donnelly C, Jenkinson E, Rizkalla J, Langford N. Bupropion toxicokinetic: A case report. Clin Toxicol (Phila) 2010; 48(4): 385-7.
[http://dx.doi.org/10.3109/15563651003623289] [PMID: 20230334]
[76]
Sorbie AL, Symon DN, Stockdale EJ. Gaviscon bezoars. Arch Dis Child 1984; 59(9): 905-6.
[http://dx.doi.org/10.1136/adc.59.9.905-a] [PMID: 6091569]
[77]
Razafimahefa H, Mouterde O, Devaux AM. Esophageal bezoar in a child treated with sucralfate. Arch Pediatr 1997; 4(7): 659-61.
[http://dx.doi.org/10.1016/S0929-693X(97)83369-6] [PMID: 9295906]
[78]
Bernstein G, Jehle D, Bernaski E, Braen GR. Failure of gastric emptying and charcoal administration in fatal sustained-release theophylline overdose: pharmacobezoar formation. Ann Emerg Med 1992; 21(11): 1388-90.
[http://dx.doi.org/10.1016/S0196-0644(05)81907-9] [PMID: 1416337]
[79]
Korenman MD, Stubbs MB, Fish JC. Intestinal obstruction from medication bezoars. JAMA 1978; 240(1): 54-5.
[http://dx.doi.org/10.1001/jama.1978.03290010058028] [PMID: 307067]
[80]
Salguero Molpeceres O, Seijas Ruiz-Coello MC, Hernández Núñez J, Caballos Villar D, Díaz Picazo L, Ayerbe García-Monzón L. [Esophageal obstruction caused by dietary fiber from Plantago ovata, a complication preventable by adequate information] Gastroenterol Hepatol 2003; 26(4): 248-50.
[http://dx.doi.org/10.1157/13045198] [PMID: 12681118]
[81]
Harikumar R, Kunnel P, Sunilraj R. Dissolution of pharmacobezoar using carbonated beverage. Indian J Gastroenterol 2008; 27(6): 245-6.
[PMID: 19405260]
[82]
Sechopoulos P, Robotis JF, Rokkas T. Gastric bezoar treated endoscopically with a carbonated beverage: case report. Gastrointest Endosc 2004; 60(4): 662-4.
[http://dx.doi.org/10.1016/S0016-5107(04)01872-3] [PMID: 15472706]
[83]
Ladas SD, Triantafyllou K, Tzathas C, Tassios P, Rokkas T, Raptis SA. Gastric phytobezoars may be treated by nasogastric Coca-Cola lavage. Eur J Gastroenterol Hepatol 2002; 14(7): 801-3.
[http://dx.doi.org/10.1097/00042737-200207000-00017] [PMID: 12169994]
[84]
Chung YW, Han DS, Park YK, et al. Huge gastric diospyrobezoars successfully treated by oral intake and endoscopic injection of Coca-Cola. Dig Liver Dis 2006 Jul; 38(7): 515-7.
[http://dx.doi.org/10.1016/j.dld.2005.10.024] [PMID: 16330268]
[85]
Djogovic D, Hudson D, Jacka M. Gastric bezoar following venlafaxine overdose. Clin Toxicol (Phila) 2007; 45(6): 735.
[http://dx.doi.org/10.1080/15563650701517731] [PMID: 17849255]
[86]
Townsend CM Jr, Remmers AR Jr, Sarles HE, Fish JC. Intestinal obstruction from medication bezoar in patients with renal failure. N Engl J Med 1973; 288(20): 1058-9.
[http://dx.doi.org/10.1056/NEJM197305172882007] [PMID: 4540497]
[87]
Rivera W, Kleinschmidt KC, Velez LI, Shepherd G, Keyes DC. Delayed salicylate toxicity at 35 hours without early manifestations following a single salicylate ingestion. Ann Pharmacother 2004; 38(7-8): 1186-8.
[http://dx.doi.org/10.1345/aph.1D575] [PMID: 15173556]
[88]
Gayer G, Gotlieb WH, Apter S. Paraffin oil bezoar impacted in the small bowel: CT findings. Br J Radiol 2000; 73(875): 1213-4.
[http://dx.doi.org/10.1259/bjr.73.875.11144801] [PMID: 11144801]
[89]
Hewitt GJ, Benham ES. A complication of Gaviscon in a neonate - “the Gavisconoma. Aust Paediatr J 1976; 12(1): 47-8.
[http://dx.doi.org/10.1111/j.1440-1754.1976.tb02834.x] [PMID: 962731]
[90]
Erdemir A, Ağalar F, Çakmakçı M, Ramadan S, Baloğlu H. A rare cause of mechanical intestinal obstruction: Pharmacobezoar. Ulus Cerrahi Derg 2015; 31(2): 92-3.
[http://dx.doi.org/10.5152/UCD.2014.2749] [PMID: 26170758]
[91]
Sinaasappel M, den Ouden WJ, Luyendijk I, Degenhart HJ. Increased vomiting induced by an antiemetic drug. Arch Dis Child 1984; 59(3): 272-4.
[http://dx.doi.org/10.1136/adc.59.3.272] [PMID: 6324701]
[92]
Faverge B, Gratecos LA. Gastric lactobezoar in an infant induced by Gelopectose. Pediatrie 1987; 42(9): 685-6.
[PMID: 2836788]
[93]
Mercier JC, Hartmann JF, Cohen R, Tran H, Biriotti V, Kessler A. Intestinal occlusion and enterocolitis caused by Gelopectose. Arch Fr Pediatr 1984; 41(10): 709-10.
[PMID: 6532359]
[94]
Heinz-Erian P, Gassner I, Klein-Franke A, Jud V, Trawoeger R, Niederwanger C, et al. Gastric lactobezoar - a rare disorder. Orphanet J Rare Dis 2012; 7: 3.
[http://dx.doi.org/10.1186/1750-1172-7-3] [PMID: 22216886]
[95]
Iberti TJ, Patterson BK, Fisher CJ Jr. Prolonged bromide intoxication resulting from a gastric bezoar. Arch Intern Med 1984; 144(2): 402-3.
[http://dx.doi.org/10.1001/archinte.1984.00350140236034] [PMID: 6696579]
[96]
Stack PE, Patel NR, Young MF, Ferslew KE, Thomas E. Pharmacobezoars--the irony of the antidote: first case report of nifedipine XL bezoar. J Clin Gastroenterol 1994; 19(3): 264-5.
[http://dx.doi.org/10.1097/00004836-199410000-00020] [PMID: 7806842]
[97]
Prisant LM, Carr AA, Bottini PB, Kaesemeyer WH. Nifedipine GITS (gastrointestinal therapeutic system) bezoar. Arch Intern Med 1991; 151(9): 1868-9.
[http://dx.doi.org/10.1001/archinte.1991.00400090140025] [PMID: 1888255]
[98]
Hopkins LE, Sunkersing J, Jacques A. Too many pills to swallow: A case of a mixed overdose. J Intensive Care Soc 2017; 18(3): 247-50.
[http://dx.doi.org/10.1177/1751143717693860] [PMID: 29118840]
[99]
Abraham SC, Bhagavan BS, Lee LA, Rashid A, Wu TT. Upper gastrointestinal tract injury in patients receiving kayexalate (sodium polystyrene sulfonate) in sorbitol: clinical, endoscopic, and histopathologic findings. Am J Surg Pathol 2001; 25(5): 637-44.
[http://dx.doi.org/10.1097/00000478-200105000-00011] [PMID: 11342776]
[100]
Ciobanu L, Pascu O, Tantau M, et al. Intra-esophageal whitish mass - a challenging diagnosis. BMC Gastroenterol 2015; 15: 106.
[http://dx.doi.org/10.1186/s12876-015-0335-x] [PMID: 26285706]
[101]
Sporer KA, Manning JJ. Massive ingestion of sustained-release verapamil with a concretion and bowel infarction. Ann Emerg Med 1993; 22(3): 603-5.
[http://dx.doi.org/10.1016/S0196-0644(05)81953-5] [PMID: 8442554]
[102]
Cereda JM, Scott J, Quigley EM. Endoscopic removal of pharmacobezoar of slow release theophylline. Br Med J (Clin Res Ed) 1986; 293(6555): 1143.
[http://dx.doi.org/10.1136/bmj.293.6555.1143] [PMID: 3094809]
[103]
Angueira C, Kadakia S. Esophageal and duodenal bezoars from Perdiem. Gastrointest Endosc 1993; 39(1): 110-1.
[http://dx.doi.org/10.1016/S0016-5107(93)70038-3] [PMID: 8454137]
[104]
Schapira M, Henrion J, Jonard P, Ghilain JM, Maisin JM, Heller F. Esophageal bezoar: report of five more cases. Endoscopy 1995; 27(4): 342.
[http://dx.doi.org/10.1055/s-2007-1005705] [PMID: 7555943]
[105]
Lapostolle F, Finot MA, Adnet F, Borron SW, Baud FJ, Bismuth C. Radiopacity of clomipramine conglomerations and unsuccessful endoscopy: report of 4 cases. J Toxicol Clin Toxicol 2000; 38(5): 477-82.
[http://dx.doi.org/10.1081/CLT-100102006] [PMID: 10981957]
[106]
Furuya R, Okada Y, Inagawa H, et al. A case of relapse into deep coma following repeated doses of activated charcoal administered in response to an overdose of vegetamin b (a combination of phenobarbital, chlorpromazine, and promethazine). Nihon Kyuk Igaku Zass 2008; 19(2): 106-12.
[http://dx.doi.org/10.3893/jjaam.19.106]
[107]
Costa R, Oliveira NG, Dinis-Oliveira RJ. Pharmacokinetic and pharmacodynamic of bupropion: integrative overview of relevant clinical and forensic aspects. Drug Metab Rev 2019; 51(3): 293-313.
[http://dx.doi.org/10.1080/03602532.2019.1620763] [PMID: 31124380]
[108]
Reid T, Rubins JB, Levine J, DeCelles J, Silvis S. Colonic medication bezoar from extended-release nifedipine and procainamide. Arch Fam Med 1995; 4(8): 715-7.
[http://dx.doi.org/10.1001/archfami.4.8.715] [PMID: 7620602]
[109]
Trece ASN, Peixoto Netto LP, Trece RL, Bravo FP, Castro Júnior PC, Paulo FL. Doença de Crohn e farmacobezoar intestinal: relato de caso. Rev Bras Coloproctol 2010; 30: 215-20.
[http://dx.doi.org/10.1590/S0101-98802010000200014]
[110]
Albuquerque ICd. Carvalho MA, Batista RR, Formiga GJS. Bezoar by mesalazine tablets: cause of intestinal obstruction in crohn’s disease. J Coloproctol 2012; 32(4): 422-5.
[http://dx.doi.org/10.1590/S2237-93632012000400011]

Rights & Permissions Print Cite
Article Metrics
87
Wayfinder Image
Open Access Journals Promotions
© 2024 Bentham Science Publishers | Privacy Policy