Observation of the effect of comprehensive internal medical treatment including gastric endoscopy on patients with bezoar / 中国综合临床

Objective To investigate the effect of comprehensive internal medical treatment including gastric endoscopy on patients with bezoar. Methods From 2010 to 2016,a retrospective study was conducted on fifty?two patients admitted to Beijing Shijitan Hospital, Capital Medical University. Results The main accompanying diseases were hypertension,coronary heart disease,diabetes mellitus and so on. Food that are easy to induce bezoar : banana, persimmon, hawthorn, chestnut, etc. The treatment included endoscopic treatment, intravenous proton pump suppression, and oral Coca?Cola and bicarbonate solution. The bezoar in two patients after 3 weeks of medical treatment were still not dissolved,finally surgery were performed. One patient's pathology showed early cardiac adenocarcinoma. Five patients had incomplete intestinal obstruction, after fasting and gastrointestinal decompression, and the bezoars were excreted through feces. All patients were cured without death. Conclusion Gastroscopy is a timely treatment that can help diagnose and treat gastric bezoar. The main predisposing factors include hypertension, coronary heart disease, diabetes mellitus and so on. Endoscopic treatment,intravenous proton pump inhibitor,sodium bicarbonate and Coca?Cola could dissolve most bezoar. We should be alert to the possibility of early cancer.

A Case of Gastric Bezoar Treated with a Distal Attachment Device / 대한소화기내시경학회지

Bezoars are collection of indigestible materials in the gastrointestinal tract. Many endoscopic techniques for removal of bezoars have been reported recently, but these methods need much equipment. We treated a gastric bezoar with a distal attachment device easily available for an endoscope. A 74-year-old man with a history of diabetes mellitus was admitted to hospital with hematemesis. On the second endoscopic examination, a gastric bezoar (6x4x4 cm) was detected in the stomach. Then, using a distal attachment device, we injected Coca-Cola directly into the bezoar by an injector. With tension force, the bezoar was easily broken due to the impulse of the distal attachment device. The endoscopic technique used in our case can be easily performed and has fewer complications compared to those of other techniques. Therefore, we report here on this new treatment modality that uses a distal attachment device.

A case of a huge gastric bezoar treated with an endoscopic Coca-cola injection and an Argon plasma beam / 대한내과학회지

Bezoars are persistent concretions of indigestible materials found in the stomach. They can cause mucosal ulceration or wall perforation, gastritis, gastric outlet obstruction, or gastrointestinal bleeding. With the significant development of endoscopic techniques, many authors have reported the removal of bezoars using methods such as endoscopic mechanical lithotomy and chemical dissolution however, the outcomes differ according to the treatment method. We report a case treated successfully with an endoscopic Coca-cola injection and an argon plasma beam for 90 minutes. A 61-year-old man was admitted with a 4-day history of upper abdominal pain. A bezoar was detected by upper gastrointestinal endoscopy. The bezoar (10x8x6 cm) was dark brown in color and extremely hard. Attemptat endoscopic removal using a polypectomy snare failed. We then injected Coca-cola directly into the bezoar mass and sprayed it with an Argon plasma beam. Ninety minutes later, the bezoar was broken into pieces and removed. The bezoar was absent at the follow up endoscopy 2 weeks later.

A Huge Gastric Bezoar That Was Removed by Endoscopic Combination Therapy with an Argon Plasma and Coca-Cola Injection / 대한소화기내시경학회지

Bezoars are collections or concretions of indigestible foreign material in the gastrointestinal tract. In the past, the most common method for the treatment of bezoar was surgical management. The current treatment methods for bezoars include chemical dissolution and endoscopic lithotripsy using biopsy forceps and, snare, electrohydraulic lithotripsy and laser. Cases of endoscopic fragmentation of gastric bezoars using an argon plasma and dissolution of gastric bezoars with Cola have recently been described, but it took a long time in those cases to remove a bezoar by a single method. Moreover, fragmented, residual bezoar-related complications sometimes occurred. We report here on a case of a 35-year-old man with a 10x8x8 cm sized huge gastric bezoar that was successfully removed by combination therapy using an argon plasma and Coca-Cola injection. Compared with the previous single method, combination therapy using an argon plasma and Coca-Cola injection shortened the procedure time and reduced the complications related to a fragmented, remaining bezoar.

A gastric bezoar treated with an endoscopic urokinase injection / 대한내과학회지

Bezoars are collections or concretions of indigestible foreign material that accumulate and coalesce in the gastrointestinal tract. Treatment options include dissolution with enzymes, endoscopic removal or aspiration, and surgery. The outcome differs according to the treatment method. A 57-year-old man was admitted with a 1-month history of epigastric pain. On gastrofiberscopy, an approximately 2-cm deep ulcer was seen on the lesser curvature of the antrum and three huge bezoars were found. In order to remove the first one, we injected Coca-Cola into it directly. It took 20 minutes to cut up and 1 hour to remove completely. To decrease the procedure time, we changed the injection fluid to urokinase for the remaining two bezoars. It took 9 and 10 minutes to cut up the second and third bezoars, respectively, and 1 hour to remove them completely. We report a case of phytobezoars treated successfully by endoscopic injections of Coca-Cola and urokinase.

A Case of Gastric Bezoar Treated by an Endoscopic Coca-Cola Injection / 대한소화기내시경학회지

Bezoars are the most common foreign bodies in the stomach as seen endoscopically with a frequency of approximately 0.4%. They consist of persistent concretions or hard accumulations of non-digestible vegetable matter, hair or more unusual materials. Gastric bezoars develop in patients with previous gastric surgery, gastric outlet obstruction, or poor gastric emptying such as gastroparesis due to hypothyroidism, diabetes mellitus or mixed connective tissue disease. The clinical presentations of gastric bezoars include epigastric pain, a palpable mass, a gastrointestinal obstruction and peptic ulceration. The treatment options include surgery, enzymatic dissolution or endoscopic mechanical fragmentation and/or removal. Recently, the efficacy of the administration or lavage of 'Coca-Cola' for the effective dissolution of gastric bezoars has been reported. We report a case of a 27-year-old woman with a large gastric bezoar that was successfully removed by the direct endoscopic injection of a carbonated beverage ('Coca-Cola light', a sugar free product; Coca cola Co., Seoul, South Korea) into the bezoar, which led to fragmentatio

Acute Intestinal Obstruction Caused by a Persimmon Phytobezoar after Dissolution Therapy with Coca-Cola

Bezoars are concretions or hard masses of foreign matter that are found in the gastrointestinal tract. Recent reports have demonstrated the efficacy of Coca-Cola administration for the dissolution of phytobezors. Here we report on a 73-year-old man with a very large gastric persimmon diospyrobezoar, and this caused small intestinal obstruction after partial dissolution with oral and injected Coca-Cola.

2 Cases of Huge Bezoar in Geriatric Patients that Endoscopically Removed Through Direct Injection of Coca-Cola

In case of bezoar removal, pharmacotherapy has been performed within restrictive patients as well as therapeutic endoscopy has been restricted as to the size of bezoar and its hardness. In patients with huge and hard bezoars, that is unable to remove through endoscopy they need surgical removal. But in case of geriatric patient management, we can't overlook the complication of general anethesia and post operative wound infection. Thus we describe two case of geriatric patient that endoscopically removed bezoar through the medium of dissolved by Coca-Cola direct injection and lavage. We injected Coca-Cola directly to bezoar through the spray catheter and then Coca-Cola lavage daily two liters for three days. We could easily destroy dissolved huge bezoars by using of biopsy forcep and snare and than get rid of them endoscopically by use of basket. In case of geriatric patient management of huge gastric bezoar it is considered another choice for bezoar removal.

Gastric Phytobezoar Treated by Oral Intake and Endoscopic Injection of Coca-Cola / 영남의대학술지

Bezoars are collections or concretions of indigestible foreign material that accumulate and coalesce in the gastrointestinal tract; they usually occur in patients who have undergone gastric surgery and have delayed gastric emptying. Treatment options include dissolution with enzymes, endoscopic fragmentation with removal or aspiration, and surgery. Recently, the efficacy of nasogastric lavage or endoscopic infusion of Coca-Cola for the dissolution of phytobezoar have been reported. We report a case of phytobezoar successfully treated by oral administration and endoscopic injection of Coca-Cola. A 62-year-old woman was referred to Yeungnam University Hospital for epigastric pain. Upper gastrointestinal endoscopy revealed one very large, dark-greenish, solid bezoar in the stomach with gastric ulcer and duodenal bulb deformity. We performed endoscopic injection of Coca-Cola into the bezoar. The patient was instructed to drink four liters of Coca-Cola per day. At endoscopy two days later, the phytobezoar was easily broken into pieces. At endoscopy on the 11th day of admission, the phytobezoar was decreased in size and removed by endoscopic fragmentation with a polypectomy snare. At follow up endoscopy after 13 days, the bezoar was completely dissolved.