The aim of this study was to reassess the clinical and radiographic findings in a series of patients with gastric
bezoars. Radiology files revealed 19 patients with
bezoars; 10 patients had CT and 10 had endoscopy before or after the
barium studies. 11 patients (58%) had risk factors for
gastroparesis and 6 (32%) had had previous gastric surgery, including 3 having had a
gastric bypass or
vertical banded gastroplasty. 18 patients (95%) had symptoms; in 10 of those patients, symptoms were present for 1 week or less (53%). On
barium studies, the
bezoars were round or ovoid in 17 patients (89%) and irregular in 2 (11%); mottled in 10 (53%) and homogeneous in 9 (47%); and mobile in 15 (79%) and immobile in 4 (21%).
Gastroparesis was observed at fluoroscopy in 8 (62%) out of 13 patients without gastric surgery. Symptoms improved/resolved in 12 (67%) out of 18 patients. Follow-up CT or endoscopy showed resolution of the
bezoars in 8 (80%) out of 10 patients; the mean interval to resolution was 12 days. Our experience suggests that
gastroparesis is the single most common cause of
bezoars, accounting for the majority of cases. Partial gastric resection or
bariatric surgery should also be recognized as a cause of
bezoar formation. These lesions may be manifested on
barium studies by a spectrum of findings, appearing as mottled or homogeneous, mobile or immobile masses, sometimes filling the gastric pouch after
bariatric surgery. Affected individuals often have an acute clinical presentation with symptoms for 1 week or less, and some
bezoars resolve rapidly on conservative medical treatment.