Endoscopic treatment of bezoars. A critical review of the literature and presentation of two cases.

The authors report two cases of bezoars. The first was a large gastric bezoar in a patient who had undergone Billroth II gastroresection 40 years earlier. The second was a bezoar located in the distal part of the sigmoid colon accompanied by acute diverticular disease. Both bezoars were removed using endoscopic techniques. The method of exeresis is described together with the characteristics of the different anatomic sites. The authors review the literature focusing on nosology, symptomatology, diagnosis and guidelines for therapy. Considerable attention is paid to the use of endoscopy associated with prokinetic-enzymatic medical therapy. Surgery is reserved for rare cases of endoscopic failure, mostly recorded in the event of trichobezoars following the onset of intestinal occlusions caused by migration, or lastly when the cause of the bezoar is a pre-existing organic or functional stenosis.