Large Gastric Bezoar

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GASTRIC bezoars are rare medical curiosities. They are considered of historical interest because animal bezoars were thought, in the Middle Ages, to possess certain curative powers. Among the crown jewels of Queen Elizabeth were two large bezoar stones. The bezoar was listed in the London pharmacopeias until the mid-eighteenth century. DeBakey and Ochsner1 state, “It neutralized poisons, reanimated old age, destroyed venoms, and counteracted attacks of vertigo, epilepsy, dysentery, plague, leprosy, etc.”

Bezoars are unusual in humans. DeBakey and Ochsner1 in a careful review of the literature were able to find only 303 collected cases, to which they added 8 of their own in 1938. These foreign bodies occur most frequently in the psychiatric patient who has formed the habit of eating hair, string, and other indigestible materials. The incidence of bezoars outside psychiatric institutions is extremely rare, and the case we are reporting is the only one ever observed at the Cleveland Clinic.

Bezoars may be composed of several different materials, the most common the trichobezoar or hair ball. Next in incidence is the phytobezoar, of vegetable composition. While the most ordinary type originates from persimmon seeds,2 it may be caused by other types of vegetable and plant substance. The third type of bezoar is the concretion, which may result from the ingestion of furniture polish for its alcoholic content — the shellac being precipitated and forming a gummy bezoar. Other concretions have been caused by bismuth, magnesium, calcium and sodium carbonates, and by salol.3

The symptoms and clinical manifestations. . .



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