Document Type : Case reports

Authors

• Fardad Ejtehadi ¹
• Amir Anushiravani ²
• Ehsan Zare ²
• Mohammad Reza Pashaei ³
• Maryam Moini ⁴

¹ Therapeutic Endoscopy and Advanced ERCP Ward, Namazi Hospital, Gastroenterology and Hepatology Section, Internal Medicine Department, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran

² Gastroenterohepatology Research Center, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran

³ Department of Gastroenterology, Urmia University of Medical Sciences, Urmia, Iran

⁴ Department of Internal Medicine, Gastroenterology and Hepatology Section, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran

Abstract

Introduction: Gastric bezoars are formed by accumulation of non - digestible material in the stomach. They are found mostly in patients with delayed gastric emptying or special psychiatric diseases. Therapeutic options are medical dissolution therapy and endoscopic techniques. Surgery options are kept for refractory or emergency cases.
Case Presentation: We report 2 cases of successful non surgery, endoscopic treatment of huge gastric bezoars, which were refrac- tory to medical dissolution therapy and conventional endoscopic techniques such as bezoar fragmentation by polypectomy snare, Basket, Argon Plasma Coagulation device, and different types of foreign body retrieval forceps. In June 2015 and September 2017 in the Namazi hospital (Shiraz University of Medical Sciences, Iran) bezoars fragmentation were conducted successfully by elec- trohydraulic lithotripsy catheter (Nortech Aoutolith and copy, Northgate technologies, INC.) under direct visualization during the endoscopy. This instrument is primarily designed to crush urinary tract and bile ducts stones avoiding open surgery. Taking the
advantages of its capabilities, we used electrohydraulic lithotripsy catheter for huge gastric bezoar fragmentation.
Conclusions: In the endoscopic treatment refractory gastric bezoars, electrohydraulic lithotripsy can be used as an excellent alter- native option to surgery. This technique is safe, feasible, and uncomplicated without any need for surgery.

Keywords

• Bezoar
• Foreign Body
• Lithotripsy