Gastrointestinal bezoars: sonographic and CT characteristics

TL;DR: Both sonography and CT are reliable methods for diagnosing gastrointestinal bezoars.

Abstract: Objective The purpose of this study was to assess the value of imaging studies--conventional abdominal radiographs, sonography, and CT--in the diagnosis of gastrointestinal bezoars. Methods and methods A review was made of the radiologic findings of 17 consecutive patients with surgically verified gastrointestinal bezoars over a period of 51 months. Results Twelve patients had a history of previous gastric surgery. In no patient was a bezoar clinically suspected. Phytobezoars were recorded in 16 patients and a trichobezoar in only one. A total of 33 bezoars were identified at surgery. Two patients had isolated gastric bezoars, whereas 15 patients had bezoars located in the small bowel. Among the latter group, associated gastric bezoars were found in eight patients, and five patients had multiple intestinal bezoars. Abdominal radiographs revealed bezoars in three patients, sonography revealed bezoars in 15, and CT revealed bezoars in all 17. Seven patients had associated gastric bezoars revealed at CT versus only two patients with gastric bezoars revealed at sonography. CT revealed multiple intestinal bezoars in five patients whereas sonography revealed them in only two patients. Conclusion Both sonography and CT are reliable methods for diagnosing gastrointestinal bezoars. CT is more accurate, however, and exhibits a quite characteristic bezoar image; in addition, this imaging technique is able to reveal the presence of additional gastrointestinal bezoars.