1
|
Li CY, Zhou XR, Wang J, Du ZQ. A simple lithotripsy method for gastric bezoars: Zebra guidewire combined with transparent cap. Asian J Surg 2024:S1015-9584(24)01780-9. [PMID: 39191584 DOI: 10.1016/j.asjsur.2024.08.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2024] [Accepted: 08/02/2024] [Indexed: 08/29/2024] Open
Affiliation(s)
- Chun-Yan Li
- Department of Gastroenterology, Jianyang People's Hospital, Jianyang, Sichuan Province, China
| | - Xiang-Rong Zhou
- Department of Gastroenterology, Jianyang People's Hospital, Jianyang, Sichuan Province, China
| | - Jin Wang
- Department of Gastroenterology, Jianyang People's Hospital, Jianyang, Sichuan Province, China
| | - Zhi-Qiang Du
- Department of Gastroenterology, Jianyang People's Hospital, Jianyang, Sichuan Province, China.
| |
Collapse
|
2
|
Shu J, Zhang H. Tennis ball cord combined with endoscopy for giant gastric phytobezoar: A case report. World J Clin Cases 2024; 12:3603-3608. [PMID: 38983432 PMCID: PMC11229917 DOI: 10.12998/wjcc.v12.i18.3603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 04/22/2024] [Accepted: 05/15/2024] [Indexed: 06/13/2024] Open
Abstract
BACKGROUND Due to the specificity of Chinese food types, gastric phytobezoars are relatively common in China. Most gastric phytobezoars can be removed by chemical enzyme lysis and endoscopic fragmentation, but the treatment for large phytobezoars is limited, and surgical procedures are often required for this difficult problem. CASE SUMMARY For giant gastric phytobezoars that cannot be dissolved and fragmented by conventional treatment, we have invented a new lithotripsy technique (tennis ball cord combined with endoscopy) for these phytobezoars. This non-interventional treatment was successful in a patient whose abdominal pain was immediately relieved, and the gastroscope-induced ulcer healed well 3 d after lithotripsy. The patient was followed-up for 8 wk postoperatively and showed no discomfort such as abdominal pain. CONCLUSION The combination of tennis ball cord and endoscopy for the treatment of giant gastric phytobezoars is feasible and showed high safety and effectiveness, and can be widely applied in hospitals of all sizes.
Collapse
Affiliation(s)
- Juan Shu
- Department of Gastroenterology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430014, Hubei Province, China
| | - Heng Zhang
- Department of Gastroenterology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430014, Hubei Province, China
| |
Collapse
|
3
|
Oliveira C, Nunes G, Vara-Luiz F, Paiva de Oliveira G, Nunes A, Fonseca J. Endoscopic Extraction of Two Giant Stone Bezoars Using Mechanical and Laser Lithotripsy: Remoção endoscópica de dois bezoares gigantes petrificados com recurso a litotrícia mecânica e por laser. GE PORTUGUESE JOURNAL OF GASTROENTEROLOGY 2024; 31:212-214. [PMID: 38836120 PMCID: PMC11149997 DOI: 10.1159/000533931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Accepted: 07/31/2023] [Indexed: 06/06/2024]
Affiliation(s)
- Carla Oliveira
- Gastroenterology Department, Hospital Garcia de Orta, Almada, Portugal
| | - Gonçalo Nunes
- Gastroenterology Department, Hospital Garcia de Orta, Almada, Portugal
- PaMNEC - Grupo de Patologia Médica, Nutrição e Estudos Clínicos, CiiEM, Centro de Investigação Interdisciplinar Egas Moniz, Monte da Caparica, Portugal
| | - Francisco Vara-Luiz
- Gastroenterology Department, Hospital Garcia de Orta, Almada, Portugal
- PaMNEC - Grupo de Patologia Médica, Nutrição e Estudos Clínicos, CiiEM, Centro de Investigação Interdisciplinar Egas Moniz, Monte da Caparica, Portugal
| | | | - Ana Nunes
- Gastroenterology Department, Hospital Garcia de Orta, Almada, Portugal
| | - Jorge Fonseca
- Gastroenterology Department, Hospital Garcia de Orta, Almada, Portugal
- PaMNEC - Grupo de Patologia Médica, Nutrição e Estudos Clínicos, CiiEM, Centro de Investigação Interdisciplinar Egas Moniz, Monte da Caparica, Portugal
| |
Collapse
|
4
|
Korekawa K, Orikasa M, Kunimitsu A. Intestinal Obstruction Due to Reassembly after Endoscopic Crushing of a Bezoar. Intern Med 2023; 62:2965-2969. [PMID: 36889702 PMCID: PMC10641210 DOI: 10.2169/internalmedicine.1582-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Accepted: 02/01/2023] [Indexed: 03/09/2023] Open
Abstract
An 87-year-old woman visited her primary-care doctor because of nausea and epigastric pain. Esophagogastroduodenoscopy (EGD) revealed a giant bezoar in her stomach. She was referred to our hospital after carbonated beverage dissolution proved ineffective and underwent endoscopic mechanical crushing. After crushing, the symptoms disappeared, and she began eating. Later, however, the crushed fragments reassembled in the duodenal bulb and caused intestinal obstruction. The patient underwent emergency EGD for crushing once more, and all of the fragments were extracted from the body. This case highlights the need for bezoars to be removed from the body after crushing in order to avoid reassembly.
Collapse
Affiliation(s)
- Kai Korekawa
- Department of Gastroenterology, Hachinohe City Hospital, Japan
- Division of Gastroenterology, Tohoku University Graduate School of Medicine, Japan
| | | | - Atsushi Kunimitsu
- Department of Gastroenterology, Hachinohe City Hospital, Japan
- Department of Surgery, Tohoku University Graduate School of Medicine, Japan
| |
Collapse
|
5
|
Miyazawa M, Kumai T, Kawakami T, Ohta H, Yonejima M. Removal of a giant gastric bezoar with the grasp-and-smash technique through a double-channel endoscope. Endosc Int Open 2021; 9:E925-E926. [PMID: 34079879 PMCID: PMC8159613 DOI: 10.1055/a-1401-3782] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
- Masaki Miyazawa
- Tsuruga Municipal Hospital, Department of Gastroenterology, Fukui, Japan
| | - Tatsuo Kumai
- Tsuruga Municipal Hospital, Department of Gastroenterology, Fukui, Japan
| | - Takumi Kawakami
- Tsuruga Municipal Hospital, Department of Gastroenterology, Fukui, Japan
| | - Hajime Ohta
- Tsuruga Municipal Hospital, Department of Gastroenterology, Fukui, Japan
| | - Manabu Yonejima
- Tsuruga Municipal Hospital, Department of Gastroenterology, Fukui, Japan
| |
Collapse
|
6
|
Sun M, Pan S, Liang Y, Wei X. Removal of a duodenal cyanoacrylate glue bezoar with a snare and cap-assisted endoscopy. Endoscopy 2021; 53:E219-E220. [PMID: 32916730 DOI: 10.1055/a-1244-9779] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Affiliation(s)
- Meixing Sun
- Department of Gastroenterology, the Third Affiliated Hospital of Sun Yat-Sen University
| | - Shuru Pan
- Department of Gastroenterology, the Third Affiliated Hospital of Sun Yat-Sen University
| | - Yanpin Liang
- Department of Gastroenterology, the Third Affiliated Hospital of Sun Yat-Sen University
| | - Xiuqing Wei
- Department of Gastroenterology, the Third Affiliated Hospital of Sun Yat-Sen University
| |
Collapse
|
7
|
Huang Z, Cheng F, Wei W. Giant gastric bezoar removal from the stomach using combined dual knife-electric snare treatment: a case report. J Int Med Res 2020; 48:300060520946523. [PMID: 32865106 PMCID: PMC7469736 DOI: 10.1177/0300060520946523] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Gastric bezoars are foreign bodies that occur when certain drugs or foods aggregate in the stomach. They cannot be digested and most are unable to pass through the pylorus. Here, we describe a giant hard gastric bezoar that was removed by using combined dual knife–electric snare treatment. This strategy has rarely been reported and can eliminate the need for surgery. The patient exhibited a giant hard gastric bezoar and reported a habit of eating persimmons. A giant persimmon bezoar was treated using a combined dual knife–electric snare approach, without any complications. Follow-up endoscopy revealed that the bezoar had been successfully removed. This report also provides a summary of the diagnostic and therapeutic courses of gastric bezoars.
Collapse
Affiliation(s)
- Zhong Huang
- Department of Gastroenterology, Zigong First People's Hospital, Zigong, China
| | - Fang Cheng
- Department of Gastroenterology, Zigong First People's Hospital, Zigong, China
| | - Wei Wei
- Department of Gastroenterology, Zigong First People's Hospital, Zigong, China
| |
Collapse
|
8
|
Lithobezoar: A Case Report and Literature Review of an Infrequent Cause of Abdominal Pain. MEDICAL BULLETIN OF SISLI ETFAL HOSPITAL 2020; 53:445-449. [PMID: 32377125 PMCID: PMC7192304 DOI: 10.14744/semb.2018.52714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Accepted: 03/19/2018] [Indexed: 11/20/2022]
Abstract
A bezoar is the accumulation of indigestible substances in the gastrointestinal system. Presently described is the case of a 47-year-old male patient who was admitted to the clinic with nausea, vomiting, pain, and abdominal distension. He had a medical history of obsessive-compulsive disorder. He had begun eating soil in the previous 3 to 4 months. Gastroscopy revealed a large, solid, clay-like mass in the stomach. Surgery was successfully performed to remove the collected soil, but unfortunately, the patient died due to an acute myocardial infarction on the postoperative fourth day. Physicians should keep bezoars in mind in cases of unexplained abdominal symptoms, especially in females and patients with psychiatric disorders. Psychiatric disorders are often ignored by surgeons during examinations, which can lead to serious and life-threatening complications.
Collapse
|
9
|
Upper Gastrointestinal Manifestation of Bezoars and the Etiological Factors: A Literature Review. Gastroenterol Res Pract 2019; 2019:5698532. [PMID: 31396274 PMCID: PMC6664490 DOI: 10.1155/2019/5698532] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2019] [Revised: 04/28/2019] [Accepted: 05/09/2019] [Indexed: 12/19/2022] Open
Abstract
A gastric bezoar is a compact mass of indigestible foreign materials that accumulate and consolidate in the stomach; however, it can be found in other sites of the gastrointestinal tract. The causative manner of this condition is complex and multifactorial. The main purpose of the review was to raise awareness among clinicians, particularly gastroenterologists, that patients with certain risk factors or comorbid conditions are predisposed to gastric bezoar formation. Early diagnosis and prompt intervention are crucial to avoid bezoar-induced complications. Upper gastrointestinal endoscopy is the standard diagnostic and therapeutic method for gastric bezoars. However, for large size bezoars, surgical intervention is needed.
Collapse
|
10
|
Kurosu T, Tanabe S, Hasegawa R, Yano T, Wada T, Ishido K, Azuma M, Katada C, Koizumi W, Moriya H, Yamashita K. A giant trichobezoar extracted by laparoscopic and endoscopic cooperative surgery (LECS). Endosc Int Open 2018; 6:E1413-E1416. [PMID: 30505935 PMCID: PMC6264922 DOI: 10.1055/a-0732-4697] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Accepted: 05/30/2018] [Indexed: 02/07/2023] Open
Abstract
A gastric bezoar is a mass that forms in the stomach. A giant gastric bezoar is particularly difficult to treat medically, and surgical therapy is selected. We describe our experience with a patient who had a giant gastric trichobezoar that was extracted by laparoscopic and endoscopic cooperative surgery (LECS) in accordance with the principles of LECS. The patient was a 32-year-old woman who presented at our hospital because of abdominal pain. Upper gastrointestinal endoscopy confirmed the presence of a giant gastric trichobezoar extending from the gastric cardia to the gastric angle. Because endoscopic removal was considered difficult, we extracted the giant gastric trichobezoar by LECS. The concurrent use of endoscopy was considered to allow a gastric bezoar to be extracted more safely and reliably than was previously possible.
Collapse
Affiliation(s)
- Takahiro Kurosu
- Department of Gastroenterology, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan,Corresponding author Takahiro Kurosu, MD Department of GastroenterologyKitasato University School of Medicine2-1-1 AsamizodaiMinami-kuSagamiharaKanagawa 252-0380Japan+81-42-7498690
| | - Satoshi Tanabe
- Research & Development Center for New Medical Frontiers, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
| | - Rikiya Hasegawa
- Department of Gastroenterology, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
| | - Takafumi Yano
- Department of Gastroenterology, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
| | - Takuya Wada
- Department of Gastroenterology, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
| | - Kenji Ishido
- Department of Gastroenterology, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
| | - Mizutomo Azuma
- Department of Gastroenterology, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
| | - Chikatoshi Katada
- Department of Gastroenterology, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
| | - Wasaburo Koizumi
- Department of Gastroenterology, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
| | - Hiromitsu Moriya
- Department of Surgery, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
| | - Keishi Yamashita
- Department of Surgery, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
| |
Collapse
|
11
|
Khan S, Khan IA, Ullah K, Khan S, Wang X, Zhu LP, Rehman MU, Chen X, Wang BM. Etiological aspects of intragastric bezoars and its associations to the gastric function implications: A case report and a literature review. Medicine (Baltimore) 2018; 97:e11320. [PMID: 29979404 PMCID: PMC6076189 DOI: 10.1097/md.0000000000011320] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
RATIONALE Intragastric bezoar is a stony mass found trapped in the stomach, though it can occur in other locations of the gastro-intestinal tract. The etiology of intragastric bezoar is multifactorial, includes certain risk factors and predisposing factors such as coexisting medical disorders, anatomic abnormalities, and gastric motility disorders, which contribute to the development of intragastric bezoar. PATIENT CONCERNS In this report, we present a rare case of intragastric bezoar with epigastric pain after prolonged consumption of jujubes. To our knowledge, this is the first case of intragastric bezoar to be reported after jujubes ingestion. DIAGNOSES An upper gastrointestinal (GI) endoscopy performed which revealed an 8 × 5-cm intragastric diospyrobezoar with an adjacent necrotic pressure ulcer of size 0.8 × 0.5-cm without signs of bleeding. INTERVENTIONS For therapeutic intervention, Coca-Cola ingestion and lithotripsy were applied. OUTCOMES The therapeutic course was uneventful. There was no recurrence during 1-year follow-up. LESSONS In our literature, jujube emerged as a new player. A bezoar composed of unripened fruit content in the stomach, could be the cause of chronic abdominal pain, dyspepsia, gastric reflux or heartburn. Moreover, this study provides a detailed overview of recently published literature regarding intragastric manifestations of bezoar, etiological factors, diagnostic and therapeutic approaches.
Collapse
Affiliation(s)
| | | | - Kifayat Ullah
- Department of Orthopedics, Tianjin Medical University Fourth Central Hospital
| | - Saima Khan
- Department of Infertility and Reproductive Endocrinology, Tianjin Medical University Central Hospital of Obstetrics & Gynecology
| | - Xuan Wang
- Department of Gastroenterology and Hepatology
| | | | - Mujeeb ur Rehman
- Department of Cardiovascular Surgeries, Tianjin Medical University General Hospital, Tianjin, PR China
| | - Xin Chen
- Department of Gastroenterology and Hepatology
| | | |
Collapse
|
12
|
Cannalire G, Conti L, Celoni M, Grassi C, Cella A, Bensi G, Capelli P, Biasucci G. Rapunzel syndrome: an infrequent cause of severe iron deficiency anemia and abdominal pain presenting to the pediatric emergency department. BMC Pediatr 2018; 18:125. [PMID: 29614986 PMCID: PMC5883293 DOI: 10.1186/s12887-018-1097-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Accepted: 03/23/2018] [Indexed: 11/26/2022] Open
Abstract
Background Iron deficiency anemia (IDA) and abdominal pain are commonly seen in a pediatric emergency department (8 and 18% incidence respectively in our center). They are manifestations of a wide variety of diseases ranging from benign to immediately life-threatening. Trichobezoar is an under-diagnosed entity that has to be considered in children and adolescents, expecially female, suffering from trichotillomania (compulsion to pull hair) and trichophagy (compulsion to swallow hair). When undiagnosed, gastric bezoars may cause gastric ulceration, perforation, haemorrhage and obstruction. Case presentation To underline the importance of including this pathology in the differential diagnosis of IDA and abdominal pain, we present the case of a 14 year-old girl with a huge trichobezoar which completely filled the stomach and extended into the small bowel. Since trichobezoar has an extension to the small bowel, it is classified as Rapunzel syndrome. As the bezoar couldn’t be removed by endoscopy, the girl underwent surgical intervention. The patient passed through a gradual re-feeding, with iron and vitamins supplementation, and through a psychiatric counselling. Conclusion The Rapunzel syndrome is a rare entity that may be complicated by life-threatening events. A prompt diagnosis and an appropriate therapy can reduce comorbidities. Gradual re-feeding with supplementation of micronutrients allows adequate catch-up weight with normalization of haematochemical nutritional parameters. Since many of these patients suffer from psychiatric pathology such as PICA with emotional problems and mental retardation, psychological/psychiatric counselling plays an important role in order to prevent bezoar recurrence.
Collapse
Affiliation(s)
- Giuseppe Cannalire
- Department of Pediatrics and Neonatology, Guglielmo da Saliceto Hospital, Cantone del Cristo 50, Piacenza, Italy.
| | - Luigi Conti
- Department of General, Thoracic and Breast Surgery, Guglielmo da Saliceto Hospital, Cantone del Cristo 50, Piacenza, Italy
| | - Maurizio Celoni
- Department of General, Thoracic and Breast Surgery, Guglielmo da Saliceto Hospital, Cantone del Cristo 50, Piacenza, Italy
| | - Carmine Grassi
- Department of General, Thoracic and Breast Surgery, Guglielmo da Saliceto Hospital, Cantone del Cristo 50, Piacenza, Italy
| | - Andrea Cella
- Department of Pediatrics and Neonatology, Guglielmo da Saliceto Hospital, Cantone del Cristo 50, Piacenza, Italy
| | - Giulia Bensi
- Department of Pediatrics and Neonatology, Guglielmo da Saliceto Hospital, Cantone del Cristo 50, Piacenza, Italy
| | - Patrizio Capelli
- Department of General, Thoracic and Breast Surgery, Guglielmo da Saliceto Hospital, Cantone del Cristo 50, Piacenza, Italy
| | - Giacomo Biasucci
- Department of Pediatrics and Neonatology, Guglielmo da Saliceto Hospital, Cantone del Cristo 50, Piacenza, Italy
| |
Collapse
|