At the Focal Point...
electrosurgical snare polypectomy performed externally to the anus. After the polypectomy, the rectal mucosal prolapse was still present (B). Histopathologic evaluation of the resection specimen revealed elongated, irregular crypts; an eroded surface with inflammatory exudate; and strands of smooth muscle in the lamina propria (C; H&E, orig. mag. 3100; D, H&E, orig. mag. 3200); these findings were consistent with the diagnosis of inflammatory cloacogenic polyp. The patient was advised to take a high-fiber diet, and he was treated with an orally
administered iron supplement. The symptoms resolved, and the anemia improved. Madhusudhan R. Sanaka, MD D. Roy Ferguson, MD Shannon Ulrich, LPN Ruth Sargent, LPN Division of Gastroenterology MetroHealth Medical Center Cleveland, Ohio
CHEWING GUM BEZOAR
A previously healthy 18-year-old girl was hospitalized because of recurrent epigastric pain. She reported that for a number of years she was in the habit of chewing and then swallowing at least 5 wafers of chewing gum per day. Localized epigastric tenderness was noted on examination. Bariumcontrast upper-GI radiography revealed the stomach to be filled with solid-appearing masses of material (A), the appearance being consistent with a bezoar. Upper endoscopy confirmed the presence of a gastric bezoar that comprised numerous pieces of gum and
food material. The bezoar was removed in stages by fragmenting and then extracting pieces of the gum bezoar with a net. Follow-up gastroscopy revealed no remnants of the bezoar. Yossi Rimar, MD Jay P. Babich, MD Ron Shaoul, MD Department of Pediatrics Bnai Zion Medical Center Haifa, Israel PII: S0016-5107(04)00162-2
VOLUME 59, NO. 7, 2004