Chewing gum bezoar in a pediatric patient

Background

A bezoar is a collection of indigestible material found in the gastrointestinal (GI) tract that has become large enough not to progress through the rest of the intestinal system. Bezoars are caused by both food and non-food materials. Symptoms resemble other forms of GI obstructions with post-prandial fullness, abdominal pain, nausea, vomiting, and weight loss.

Case report

A five-year-old male presented to the emergency department (ED) complaining of abdominal pain and diarrhea. He reportedly swallowed a large quantity of chewing gum a day before his presentation. A computed tomography (CT) of the abdomen and pelvis revealed a gastric bezoar due to chewing gum. The patient was successfully treated with several passes of an esophagoduodenoscopy (EGD) to remove the chewing gum mass.

Why should an emergency physician be aware of this?

Gastric bezoars are rare and can vary in their presentations. ED physicians must consider bezoars in their differential diagnosis for pediatric patients presenting with postprandial fullness, abdominal pain, nausea, vomiting, or weight loss. Complications of bezoars include ischemia and perforation. A thorough history can help delineate the material causing the bezoar. Treatment of bezoars varies and can include treatment with carbonated beverages, endoscopy, and surgery.