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

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.

Keywords: case report; digestive system; diospyros; dual knife; electric snare; endoscopy; gastroscopy; giant gastric bezoar.

Figure 1.

Clinical findings and surgical procedure in a patient with a giant gastric bezoar. (a) Gastroscopy revealed a giant hard bezoar in the stomach cavity. (b) Two grooves were created along the longitudinal axis on the bezoar surface using a dual knife. (c) Two grooves were created along the horizontal axis on the bezoar surface using a dual knife. (d) Giant gastric bezoar was fragmented by an electric snare. (e) Giant gastric bezoar fragments were removed from the stomach using a Dormia basket. (f) No bezoar fragments remained in the stomach.

Figure 2.

Schematic of giant gastric bezoar removal using combined dual knife–electric snare treatment. (a) Giant bezoar present in the stomach. (b) Giant gastric bezoar cut by a dual knife. (c) Two grooves created along the longitudinal axis on the bezoar surface using a dual knife. (d) Two grooves created along the horizontal axis on the bezoar surface using a dual knife. (e) Giant gastric bezoar fragmented by an electric snare. (f) Giant gastric bezoar fragments. (g–i) Grooves of gastric bezoar fragments excavated using a dual knife and removed using a Dormia basket.