A bezoar is a tightly packed mass of foreign indigestible material in the gastrointestinal tract, usually in the stomach, but occasionally in the intestine. Bezoar composition varies, from phytobezoars mainly composed of fruit fibres but also vegetable fibres, skin and seeds. There are a small number of case reports of these developing in patients post repair of OA/TOF in childhood, and they have been reported in adults post colonic transposition in childhood.
Symptoms include abdominal pain, nausea, vomiting, early satiety, anorexia and weight loss. Uncommon presentations include gastrointestinal bleeding due to concurrent gastric ulcers and gastric outlet obstruction. Physical examination may include an abdominal bezoar mass and halitosis but it may be normal.
If suspected, investigation includes radiological investigations such as chest X-ray, abdominal ultrasound or CT. Gastroscopy can also be used, both to visualise the bezoar and remove it. However, many can be dissolved with either repeated drinking of Coca Cola, nasal lavage with Coca Cola, or incorporation of lavage and gastroscopy with Coca Cola. Surgical removal is occasionally needed. (177,188,189)
