{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T16:46:15Z","timestamp":1782578775506,"version":"3.54.5"},"reference-count":23,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2007,4,10]],"date-time":"2007-04-10T00:00:00Z","timestamp":1176163200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2007,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Gastrointestinal bezoar (GIB) is uncommon and is reported to occur in 4% of all admissions for small\u2010bowel obstruction (SBO). Because of a lack of diagnostic features, it is often associated with a delay in treatment, with increased morbidity. In this article, we report our experience with managing bezoar\u2010induced SBO and the role of early computed tomography (CT) imaging in establishing the diagnosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively reviewed all cases of bezoar\u2010induced SBO treated in our unit between 1999 and 2005.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 43 patients, of whom 2 had a recurrence, giving a total of 45 episodes. The frequency of bezoar in our patients presenting with SBO was 4.3%. All patients were of Asian origin: 41 Chinese, 1 Indian, and 1\u00a0Malay. Twenty\u2010eight (65%) patients had previous abdominal surgery of which 26 were gastric surgery. Thirty\u2010eight (88%) patients were edentulous. Forty\u2010one (91%) underwent serial abdominal radiography, whereas only 4 patients (9%) had either CT imaging or contrast study alone. Only 11 (24%) cases had a correct diagnosis of bezoar impaction made preoperatively by CT imaging. The diagnostic accuracy of CT imaging in our series was 65%, with six cases of misdiagnosis. Overall, CT led to a change in management of 76% (13\u00a0in 17). The median time to surgery from admission was 2 (0\u20130) days. There were 2 cases of ischemic bowel that necessitated bowel resection. The median length of hospital stay was 11 (5\u2013100) days. Ten patients (22%) had postoperative complications, and there was one death.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Bezoar\u2010induced SBO is uncommon and remains a diagnostic and management challenge. It should be suspected in patients with an increased risk of formation of GIB, such as previous gastric surgery, poor dentition, and a suggestive history of increased fibre intake. We advocate that CT imaging be performed early in these at\u2010risk patients and in patients presenting with SBO with or without a history of abdominal surgery in order to reduce unnecessary delays before appropriate surgical intervention.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-006-0619-y","type":"journal-article","created":{"date-parts":[[2007,4,9]],"date-time":"2007-04-09T15:23:13Z","timestamp":1176132193000},"page":"1073-1079","source":"Crossref","is-referenced-by-count":43,"title":["Small\u2010Bowel Obstruction Secondary to Bezoar Impaction: A Diagnostic Dilemma"],"prefix":"10.1002","volume":"31","author":[{"given":"Thomas W.","family":"Ho","sequence":"first","affiliation":[{"name":"General Surgery Tan Tock Seng Hospital 308433 Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dean C.","family":"Koh","sequence":"additional","affiliation":[{"name":"Division of Colorectal Surgery National University of Singapore Singapore 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