Korean J Crit Care Med.  1998 Jun;13(1):97-100.

Oropharyneal Bezoar in a Patient with Amyotrophic Lateral Sclerosis under Mechanical Ventilation: A case report

• Shin CS
• Ahn JM
• Kim GS
• Lee SM

Abstract

Bezoars are not uncommonly found during upper gastrointestinal investigations (UGI), are known to be associated with conditions causing stasis changes in gastrointestinal tract. We described here a curious presentation of an oropharyngea bezoar associated with medication and tube feeding. Only few cases of regurgated esophageal bezoar have been reported. A 54 years old man with amyotropic lateral sclerosis required ventilatory support. Nasogastric tube was placed, enteral feeding with special liquid diet (Geenvia TF) was begun. In addition, almagate was given via the feeding tube. Tracheotomy was done for long term mechanical ventilation support. On the 10th day of ICU stay, he complained of foreign body sensation in oral cavity. We could find a white brown colored 15cm solid mass in deep oropharynx. Some factors including sucralfate and the peripheral neuropathy have been suspected to be ascribed forming the esophageal bezoar. Gastrointestinal motility was decrease in patients with peripheral neuropathy. In this case, aluminum hydroxides, one of the aluminium substance like sucralfate, was given to the patient with the peripheral neuropathy. From this experience, we became to know that it is necessary to use the aluminium compound anti-ulcer drug with caution in the patients with the gastrointestinal depression.

Keyword

Gastrointestinal tract; antacid; bezoar; Ventilation; mechanical ventilation

MeSH Terms

Aluminum
Amyotrophic Lateral Sclerosis*
Bezoars*
Depression
Diet
Enteral Nutrition
Foreign Bodies
Gastrointestinal Motility
Gastrointestinal Tract
Humans
Hydroxides
Middle Aged
Motor Neuron Disease
Mouth
Oropharynx
Peripheral Nervous System Diseases
Respiration, Artificial*
Sensation
Sucralfate
Tracheotomy
Ventilation
Aluminum
Hydroxides
Sucralfate