TMSS Medical College Journal

Medication bezoars are rare and are composed of medications and/or medication vehicles. In nearly all reported cases the patient had one or more significant risk factors that contributed to bezoar formation. Rarely, medication bezoars can cause serious problems due to complications such as perforation, obstruction, haemorrhage. Herein, we report a 60 years old lady who presented with acute gastric obstruction. She had an uneventful recovery after endoscopic extraction of medication bezoar.

Medication bezoars are unusual entities. Medications reported to cause bezoars include aluminum hydroxide gel, enteric-coated aspirin, sucralfate, guar gum, cholestyramine, enteral feeding formulas, psyllium preparations, nifedipine XL, and meprobamate!. These patients often present with signs and symptoms consistent with an obstruction of the gastrointestinal tract and represent an even greater diagnostic challenge due to the rarity of this complication. To date, treatment of medication bezoars involves mainly physical manipulation of the bezoar through lavage, endoscopic removal, or, in most cases, surgical removal?. For the presented case, endoscopic removal were done and found the bezoar of tablet of aluminium hydroxide.had no contributing factors such as gastric surgery, psychiatric illness, diabetes mellitus but had a history of open cholecystectomy and choledicholithotomy. The patient had a history of mild dyspeptic upper abdominal pain for which she had taken anti-ulcer drugs on occasions. She took omeprazole capsule and aluminum hydroxide tablet as medication for her complaints before admission. No oral medication was given after admission to our hospital till diagnosis. On physical examination, she appeared ill, mildly anaemic, non icteric, dehydrated with tachycardiac pulse rate with low blood pressure. Her abdomen was soft but mildly tender over the epigastric area. No organomegally or mass was detected on examination. The rest of her examination was unremarkable. Laboratory test results did not show any notable abnormality except mild hyponatraemia.