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Case Reports
. 2021 Jan 27;5(4):522-524.
doi: 10.1002/jgh3.12491. eCollection 2021 Apr.

Endoscopic treatment for a giant gastric bezoar: Sequential use of electrohydraulic lithotripsy, alligator forceps, and snares

Ryuhei Jinushi  1 , Takahiko Yano  1 , Noriatsu Imamura  1 , Naoki Ishii  1
Affiliations
Case Reports

Endoscopic treatment for a giant gastric bezoar: Sequential use of electrohydraulic lithotripsy, alligator forceps, and snares

Ryuhei Jinushi et al. JGH Open. .

Abstract

A 62-year-old woman with no past history was referred to our hospital for endoscopic treatment of a large gastric bezoar measuring 10 cm in diameter. The bezoar had a hard surface and huge volume. A tunnel was created at the center of the bezoar using electrohydraulic lithotripsy and was dilated using a through-the-scope balloon. The bezoar was then gradually crushed using alligator forceps and snares to decrease the risk of intestinal obstruction by the crushed bezoar fragments. The sequential use of electrohydraulic lithotripsy, alligator forceps, and snares according to the therapeutic plan enabled the endoscopic treatment of the giant gastric bezoar without surgery.

Keywords: electrohydraulic lithotripsy; endoscopic treatment; gastric bezoar.

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Figures

Figure 1
Figure 1
(a) Sagittal computed tomography image showing a large gastric bezoar occupying the gastric body and fundus (➨). The bezoar measures 10 cm along its longest diameter. (b) Endoscopic view of a giant gastric bezoar with a blackish surface and hard texture. (c) Electrohydraulic lithotripsy is performed to create a tunnel at the center of the bezoar (➨). (d) Balloon dilation is performed after electrohydraulic lithotripsy to enlarge the tunnel. (e) The bezoar is grasped using alligator forceps and gradually crushed. (f) The bezoar is crushed using alligator forceps and snares. (g) The giant bezoar is completely crushed and removed without complications. Large fragments of the bezoar are retrieved, and small fragments are allowed to pass into the intestine.
See this image and copyright information in PMC

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