Gastrointestinal Bezoars in Children: Clinical Characteristics, Contributing Factors, and Treatment Outcomes

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Background/Objectives: Bezoars are described as masses of undigested substances that can be found within the gastrointestinal tract. This study aimed to explore the types of bezoars observed in pediatric patients and examine the underlying factors contributing to the formation of these bezoars and treatment outcomes. Method: This retrospective study was conducted at a tertiary medical center in Northern Taiwan from January 2000 to June 2023. We enrolled pediatric patients diagnosed with bezoars in the gastrointestinal tract from the medical database of esophagogastroduodenoscopy, upper gastrointestinal series, lower gastrointestinal series, abdominal computed tomography, and surgical procedural codes. Demographic characteristics, presenting symptoms, imaging findings, and clinical course were reviewed. Results: A total of 25 patients, including 14 females (56%), with a median age of 12.0 years (interquartile range: 5.9–15.0 years), were enrolled in this study. Phytobezoars were observed in 17 patients, while trichobezoars were found in 5 patients, and 3 patients had lactobezoars. The stomach was identified as the most frequent site. Among these patients, gastrointestinal anomalies were found in 15 patients (60%), with neuropsychiatric disorders in 11 patients (44%). Surgical intervention was required for 14 patients (56%), 5 patients (20%) underwent endoscopic treatment, and 6 patients (24%) passed the bezoar spontaneously. Trichobezoars (100%, p = 0.040), as well as bezoars of larger size (p = 0.005) or those located in the lower gastrointestinal tract (57%, p = 0.033), were associated with a significantly higher likelihood of requiring surgical intervention. Conclusions: Phytobezoars are the predominant type of bezoar observed in children, with gastrointestinal anomalies and neuropsychiatric disorders being potential contributing factors. Patients with trichobezoars or bezoars located in the lower gastrointestinal tract, especially those of larger size, are more likely to require surgery for treatment.

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