Abstract
Bezoars are relatively rare foreign bodies of gastrointestinal tract and often cause ileus and ulcerative lesions in the stomach and subsequent bleeding and perforation due to their size and stiffness. Therefore, the removal of bezoars is essential and recent development of devices, the endoscopic removal procedure, is often applied. However, due to their stiffness, simple endoscopic removal failed in not a few cases, and surgical removal has also been used. Recently, the efficacy of a combination therapy of endoscopic procedure and dissolution using carbonated liquid has been reported. To develop the safe and effective removal procedure, we carefully reviewed a total of 55 reported cases in this study including our 3 additional cases, successfully treated with dissolution with endoscopic fragmentation. In summary, the data showed the efficiency in the combination therapy, treating the larger size of bezoar and reducing the length of hospital stay. To the best of our knowledge, this is the largest pragmatical and clinical review for the combination therapy of dissolution and endoscopic treatment for bezoars. This review should help physicians to manage bezoars more efficiently.
Highlights
Bezoars are relatively rare abnormal concretions of indigestible organic material in the gastrointestinal tract, with a reported incidence of 0.07%–0.4% [1,2,3]
The gastroparesis is known to be related to the development of bezoars and it might worsen the symptoms of gastrointestinal tract obstruction showing nausea, vomiting, and increase of the risk of complication of ulcerative lesions [4, 5]
With the report of successful treatment of gastric bezoar using endoscopic procedure and carbon oxide fluid, we carefully reviewed a total of 55 patients, including our 3 additional patients, treated by dissolution with or without endoscopic fragmentation [6, 8,9,10,11,12,13,14, 16, 19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34] (Table 4) to develop the safe and effective manner for the removal
Summary
Bezoars are relatively rare abnormal concretions of indigestible organic material in the gastrointestinal tract, with a reported incidence of 0.07%–0.4% [1,2,3]. They are classified according to their component materials such as plant and vegetable fiber (phytobezoars), hair (trichobezoars), medication (pharmacobezoars), and milk protein in milkfed infants (lactobezoars). In this study, we reviewed 55 reported cases treated by dissolution therapy combined with or without endoscopic fragmentation introducing 3 additional cases of huge bezoars. Undigested milk protein that were successfully treated using the combination therapy This pragmatical and clinical review will help physicians to manage bezoars more efficiently
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