Gastrointestinal Bezoars
Sonographic and CT Characteristics
Tomás Ripollés1,
Javier García-Aguayo2,
María-Jesús Martínez1 and
Pedro Gil2
1
Department of Radiology, University Hospital Dr. Peset, 90 Gaspar Aguilar
Ave., 46017, Valencia, Spain.
2
Department of Radiology, Sagunto Hospital, 46017, Valencia, Spain.
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Fig. 1. —Small-bowel phytobezoar in 72-year-old man who presented with
1-day history of left lower quadrant pain. Abdominal radiograph shows mottled
gas (arrows) in left lower quadrant without small-bowel obstruction
signs.
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Fig. 2. —Small-bowel phytobezoar in 68-year-old man who had
experienced abdominal pain, nausea, and vomiting for 12 hr. Transverse
sonogram of lower abdomen reveals echogenic image with hyperechoic arclike
surface casting clear posterior acoustic shadow (arrows) in lumen of
dialted bowel loop (L).
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Fig. 3. —Small-bowel phytobezoar in 69-year-old man with a history of
persimmon ingestion 1 month before and persistent abdominal pain. He was
admitted through emergency department with absence of feces and emission of
gas for 24 hr. CT scan obtained without oral or IV contrast material shows
some dilated bowel loops (arrowheads) suggesting intestinal
obstruction and intraluminal oval mass with air retained in interstices
(arrows), which are characteristic of bezoar.
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Fig. 4. —Small-bowel phytobezoar in 43-year-old man with 3-day history
of abdominal pain with progressive abdominal distention. Unenhanced CT scan
reveals numerous loops of dilated small bowel containing air and fluid levels
suggestive of obstruction and ovoid intraluminal mass with mottled gas pattern
consistent with bezoar (arrows). Mottled mass is located in
transition zone with collapsed loop.
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Fig. 5. —73-year-old-woman who presented with 3-day history of
abdominal pain. CT scan obtained without oral or IV contrast material shows
inhomogeneous mass with mottled gas pattern (arrow) floating into
distended stomach. This appearance differs from that of ingested food
(arrowheads). Intestinal obstruction was due to another intestinal
bezoar located in jejunum (not shown).
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Fig. 6A. —71-year-old man with surgically confirmed gastric bezoar.
Value of modified window settings to detect image of bezoar is illustrated. CT
scan obtained at routine abdominal soft-tissue window and level settings
(level, 35 H; window, 200 H). Note that it is impossible to detect gastric
bezoar.
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Fig. 6B. —71-year-old man with surgically confirmed gastric bezoar.
Value of modified window settings to detect image of bezoar is illustrated. CT
scan of same region obtained with level of—119H. Note that ovoid mass
extending into stomach with inhomogeneous mottled appearance characteristic of
bezoar (arrow) is readily identifiable.
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Copyright © 2001 by the American Roentgen Ray Society.
