Gastrointestinal Tract - Original Article

A Simple Method for Endoscopic Treatment of Large Gastric Phytobezoars: “Hand-Made Bezoaratome”

Volume 32 · Issue 2 Publish Date: February 15, 2021
Bilal Toka Ahmet Tarik Eminler Cengiz Karacaer Mustafa Ihsan Uslan Aydin Seref Koksal Erkan Parlak
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Turkish Journal of Gastroenterology

Volume 32 · Issue 2

Pages: 141-147

History

Published Online: February 15, 2021

Copyright © 2021 Bilal Toka, Ahmet Tarik Eminler, Cengiz Karacaer, Mustafa Ihsan Uslan, Aydin Seref Koksal, Erkan Parlak

Bilal Toka
Department of Gastroenterology, Sakarya University Training and Research Hospital Sakarya, Turkey
Ahmet Tarik Eminler
Department of Gastroenterology, Uludağ University Faculty of Medicine, Bursa, Turkey
Cengiz Karacaer
Department of Internal Diseases, Sakarya University Faculty of Medicine, Education and Research Hospital, Sakarya, Turkey
Mustafa Ihsan Uslan
Sakarya University Faculty of Medicine, Education and Research Hospital, Department of Gastroenterology
Aydin Seref Koksal
Department of Gastroenterology and Hepatology, Sakarya University School of Medicine, Sakarya, Turkey
Erkan Parlak
Department of Gastroenterology, Sakarya University School of Medicine, Sakarya, Turkey
Toka, B., Eminler, A. T., Karacaer, C., Uslan, M. I., Koksal, A. S., & Parlak, E. (2021). A Simple Method for Endoscopic Treatment of Large Gastric Phytobezoars: “Hand-Made Bezoaratome”. Turkish Journal of Gastroenterology, 32(2), 141–147. https://doi.org/10.5152/tjg.2021.20199
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Abstract

Background/Aims: Large gastric phytobezoars are generally resistant to standard chemical or endoscopic treatments. We presented our experience of an alternative endoscopic method using a hand-made tool called a “hand-made bezoaratome” for the treatment of large gastric phytobezoars. Patients and Methods: Patients consulted or diagnosed with gastric bezoars at Education and Research Hospital between January 2015 and December 2018 were prospectively included in the study. Patients with phytobezoars of 50 mm and larger were included in the study. Patients with trichobezoars, lactobezoars, pharmacobezoars, under 18 years of age, and pregnant women were excluded. A 0.25 mm diameter guidewire and a mechanical lithotripter sheath were used to prepare the ‘’hand made bezoaratome’’. After the first procedure, patients were advised to consume 2500 ml of Coca Cola® or the same amount of pineapple juice per day, until the next procedure. Endoscopic procedures were performed at 5-day intervals until complete reabsorption of the bezoar was achieved. Patients were followed up for six weeks. Results: The study group included 37 (21 males, mean age: 57,6 ± 12,5 years) patients. The median size of the phytobezoars was 71 (50-90) mm. The median endoscopic procedure time was 853 (380-1940) seconds. The success rate for endoscopic fragmentation was found to be 100 %. No major complications occurred during the endoscopic procedures, but one patient (2.7%) required surgery for ileus due to an obstruction at the distal part of the jejunum, 61 hours after the second endoscopic session. The overall success rate of the endoscopic treatment was 97.3 %. Conclusion Using a “hand-made bezoaratome” is effective and reliable for the endoscopic treatment of large gastric bezoars.

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Article Info
Published In
Journal Turkish Journal of Gastroenterology
Volume / Issue Volume 32 · Issue 2
Pages 141-147
DOI 10.5152/tjg.2021.20199
History
Published Online February 15, 2021
Copyright
Copyright (c) 2021 Bilal Toka, Ahmet Tarik Eminler, Cengiz Karacaer, Mustafa Ihsan Uslan, Aydin Seref Koksal, Erkan Parlak
Affiliations
Bilal Toka
Department of Gastroenterology, Sakarya University Training and Research Hospital Sakarya, Turkey
Ahmet Tarik Eminler
Department of Gastroenterology, Uludağ University Faculty of Medicine, Bursa, Turkey
Cengiz Karacaer
Department of Internal Diseases, Sakarya University Faculty of Medicine, Education and Research Hospital, Sakarya, Turkey
Mustafa Ihsan Uslan
Sakarya University Faculty of Medicine, Education and Research Hospital, Department of Gastroenterology
Aydin Seref Koksal
Department of Gastroenterology and Hepatology, Sakarya University School of Medicine, Sakarya, Turkey
Erkan Parlak
Department of Gastroenterology, Sakarya University School of Medicine, Sakarya, Turkey
Cite this Article
Toka, B., Eminler, A. T., Karacaer, C., Uslan, M. I., Koksal, A. S., & Parlak, E. (2021). A Simple Method for Endoscopic Treatment of Large Gastric Phytobezoars: “Hand-Made Bezoaratome”. Turkish Journal of Gastroenterology, 32(2), 141–147. https://doi.org/10.5152/tjg.2021.20199
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