Successful endoscopic treatment of gastric phytobezoar: A case report

Ugenti, Ippazio; Travaglio, Elisabetta; Lagouvardou, Elpiniki; Iambrenghi, Onofrio Caputi; Martines, Gennaro

doi:10.1016/j.ijscr.2017.06.015

Cited by 28 publications

(34 citation statements)

References 14 publications

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“…Mechanical disintegration may be achieved using lithotripters, biopsy forceps, polypectomy snares of various size, argon plasma coagulation devices, electrosurgical knives and laser devices. Fragments may be removed using snares and Dormia baskets [63-65]. Trichobezoars are usually resistant and require surgical removal, although fragmentation with an electrosurgical knife has been mentioned [66].…”

Section: Therapeutic Approachmentioning

confidence: 99%

Pathophysiological and clinical aspects of the diagnosis and treatment of bezoars

Paschos

Chatzigeorgiadis

2019

aog

106

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Bezoars are intraluminal conglomerates of indigestible foreign materials that accumulate in the gastrointestinal (GI) tract. They consist of vegetable or fruit fibers, hairs or other substances; accordingly, bezoars are classified as phytobezoars, trichobezoars, pharmacobezoars, etc. Although sometimes asymptomatic, bezoars may cause serious symptoms, such as abdominal discomfort or pain, dysphagia, hematemesis, or even life-threatening entities (GI bleeding, obstruction or perforation). Current technological applications have contributed to the diagnostic and therapeutic approach to these masses, mainly through endoscopic techniques able to diagnose, fragment and extract bezoars, as well as laparoscopic and other surgical modalities that may be used to treat serious complications. Although bezoars were described centuries ago and the term was officially introduced in the mid nineties by Quain, they are still a demanding pathological entity. Their pathophysiology, accurate and prompt diagnosis, as well as successful and minimally invasive treatment, remain under investigation and see continuous progress. Current advances in these challenging areas are discussed in this review, which attempts to present an in-depth study of bezoars along with the well-established modalities and techniques.

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Section: Therapeutic Approachmentioning

confidence: 99%

Pathophysiological and clinical aspects of the diagnosis and treatment of bezoars

Paschos

Chatzigeorgiadis

2019

aog

106

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“…Moreover, undigested milk products which are frequently found in premature kids receiving formula foods, medications that do not properly dissolve in the GIT, pica ingestion that are characterized by a desire for substances that are mainly nonnutritious, such as ice; pagophagia, paper; papyrophagia, drywall or paint, metal; metallophagia, stones; lithophagia or soil; geophagia, glass; hyalophagia or feces; coprophagia and chalk, impaired mastication; dentate subjects and denture wearers are known to present with vastly different mastication efficacy inspissation, and honeycomb ingestion, etc (Table 1 ). [ 7 – 9 ] Other comorbid conditions such as first, coexisting medical disorders which includes psychiatric disorders, gastrointestinal amyloidosis, and certain systemic illnesses such as diabetes mellitus, cystic fibrosis, Guillain–Barre syndrome, bouveret's syndrome, hypothyroidism, renal failure, scleroderma, myotonic dystrophy, Ménétrier's disease, and hypochlorhydria or achlorhydria etc, have been associated with a higher risk of bezoar formation. Second, anatomic abnormalities include gastric diverticula's, gastric outlet obstruction, and cholecystogastric fistula.…”

Section: Discussionmentioning

confidence: 99%

“…First, conservative treatment for softening the intragastric bezoar includes (prokinetics, enzymes cellulose/papain, and Coca-Cola irrigations). [ 7 , 18 ] Second, most small size intragastric bezoars may pass through the digestive tract themselves or can be removed by upper GI endoscopic approach via (biopsy forceps, alligator forceps, polypectomy snares, needle-knife, lithotripters, argon plasma coagulation, and endoscopic lithotripsy with Nd:YAG laser-ignited mini-explosive technique). [ 7 , 19 ] Third, however, the best technique for the larger ones is surgical removal.…”

Section: Discussionmentioning

confidence: 99%

“…A laparoscopic technique with Alexis wound retractor has been used successfully in the treatment of bezoars. [ 7 ] Ulukent et al [ 20 ] reported a new modified laparoscopic method wherein an endobag is located in the stomach instead of the peritoneal cavity in order to prevent spillage of the bezoar through laparoscopic removal. Recently, holmium:YAG laser lithotripsy has shown a promising result in the management of massive gastric phytobezoar.…”

Section: Discussionmentioning

confidence: 99%

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Etiological aspects of intragastric bezoars and its associations to the gastric function implications

Khan¹,

Khan

Ullah

et al. 2018

Medicine

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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.

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“…3,4 Endoscopic treatments include the use of alligator forceps, lithotripters, needle cutters, snares, and holmium:yttrium aluminum garnet (YAG) laser lithotripsy. 5,6 Notably, holmium:YAG laser lithotripsy treatment was reported to provide a promising outcome for a patient with a giant gastric bezoar. 6 Endoscopic lithotripsy is a potential treatment for gastric bezoars; this approach is characterized by minor trauma, more rapid recovery, fewer complications, and low cost.…”

Section: Introductionmentioning

confidence: 99%

Giant gastric bezoar removal from the stomach using combined dual knife–electric snare treatment: a case report

2020

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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.

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Successful endoscopic treatment of gastric phytobezoar: A case report

Abstract: HighlightsGastric bezoars are a rare condition.Endoscopic fragmentation or aspiration is the best alternative among non invasive procedure.Effective and rapid treatment in outpatient setting is described without short or long term complications.

Cited by 28 publications

References 14 publications

Pathophysiological and clinical aspects of the diagnosis and treatment of bezoars

Pathophysiological and clinical aspects of the diagnosis and treatment of bezoars

Etiological aspects of intragastric bezoars and its associations to the gastric function implications

Giant gastric bezoar removal from the stomach using combined dual knife–electric snare treatment: a case report

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