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Case Reports
. 2022 Feb 1;61(3):335-338.
doi: 10.2169/internalmedicine.8090-21. Epub 2021 Jul 30.

Tannin-phytobezoars with Gastric Outlet Obstruction Treated by Dissolution with Administration and Endoscopic Injection of Coca-Cola®, Endoscopic Crushing, and Removal (with Video)

Kazuhiro Ota  1 , Shimpei Kawaguchi  1 , Taro Iwatsubo  1 , Shinya Nishida  1 , Hironori Tanaka  1 , Yosuke Mori  1 , Noriyuki Nakajima  1 , Akitoshi Hakoda  1 , Noriaki Sugawara  1 , Yuichi Kojima  1 , Toshihisa Takeuchi  1 , Masahiro Sakaguchi  2 , Kazuhide Higuchi  1
Affiliations
Case Reports

Tannin-phytobezoars with Gastric Outlet Obstruction Treated by Dissolution with Administration and Endoscopic Injection of Coca-Cola®, Endoscopic Crushing, and Removal (with Video)

Kazuhiro Ota et al. Intern Med. .

Abstract

A 77-year-old man complained of postmeal vomiting and sustained general fatigue. An abdominal computed tomography scan showed massive gastric expansion and fluid storage. Gastroscopy revealed four gastric bezoars that were considered to have caused pyloric ring obstruction. The patient was asked to drink 500 mL per day of Coca-Cola® for 4 days. On the fourth day, we performed endoscopic crushing and removal by injecting Coca-Cola®, cutting the softened bezoar with endoscopic snares, and collecting the pieces with endoscopic nets. We herein report (with a video presentation) a rare case of tannin-phytobezoars endoscopically removed with the administration and injection of Coca-Cola®.

Keywords: Coca-Cola®; endoscopic surgery; gastric bezoars; gastric outlet obstruction; phytobezoars; tannin.

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Conflict of interest statement

The authors state that they have no Conflict of Interest (COI).

Figures

Figure 1.
Figure 1.
Abdominal computed tomography findings. There was massive gastric expansion and fluid storage, with four 3- to 6-cm occupational high-density lesions noted in the gastric fluid (yellow arrows).
Figure 2.
Figure 2.
Gastroscopy findings. There were four gastric bezoars with a hard surface that were not crushed by typical endoscopic biopsy forceps.
Figure 3.
Figure 3.
Successful removal of bezoars. A capsule endoscope is included in the lower right corner for size comparison.
Figure 4.
Figure 4.
A component analysis of the gastric bezoars by infrared absorption spectrometry revealed that over 98% of the constituents were tannins.
See this image and copyright information in PMC

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