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July 7, 1978

Intestinal Obstruction From Medication Bezoars

JAMA. 1978;240(1):54-55. doi:10.1001/jama.1978.03290010058028

MEDICATION bezoars are an unusual cause of intestinal obstruction. In two previous reports from this institution,1,2 six cases of patients with intestinal obstruction due to aluminum hydroxide gel or aluminum hydroxide gel and polystyrene sodium sulfonate (Kayexalate) bezoars were reported. Half the patients were adults with acute renal failure, and half were children who had undergone renal transplantation. Aluminum hydroxide gel was given for phosphate binding and as an antacid, and the polystyrene sodium sulfonate was used as an intestinal ionexchange resin for potassium control. Bezoar formation from the medications was potentiated by the lack of intestinal activity and the intermittent relative dehydration from dialysis for the renal failure.

Report of Cases 

CASE 1.—  On April 22, 1977, a 32-year-old man received burns over 83% of his body surface area during an industrial flash fire. After five days of treatment at a local hospital, he was transferred to the