Journal of Yeungnam Medical Science

Case Report

A Case of Huge Gastric Bezoar Removed by Endoscopic Combination Therapy with Coca-Cola Injection.: Min Suk Jung, Jang Won Lee, Seung Hyun Lee, Dong Hyun Kim, Sang Hwan Byun, Yeong Muk Kim; Yeungnam Univ J Med. 2013;30(1):62-65. Published online June 30, 2013; DOI: https://doi.org/10.12701/yujm.2013.30.1.62

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Gastric bezoars are concretion of undigested material in the gastrointestinal tract. In the past, gastric bezoars were generally treated with surgical management. Recently, the efficacy of oral intake or endoscopic injection therapy with Coca-Cola has been reported. We report a case of a 47-year-old-man with huge gastric bezoar (4x2.5 cm) that was successfully removed by endoscopic fragmentation with Coca-Cola injection. Compared with a single endoscopic fragmentation therapy, the combination therapy with Coca-Cola injection shortened the procedure time and reduced the complication associated with fragmented bezoar.

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Successful removal of a foreign body by endoscopic balloon dilatation at the colonic stricture
Chang Jo Im, Ji Hoon Na, Hyun Sik Kim, Sung Sam Ha, Yoo Li Lim, Ji Hyeon Lee, Hee Kyoung Choi, Hee Man Kim
Yeungnam University Journal of Medicine.2016; 33(1): 29. CrossRef

Original Article

A Case of Gastric Bezoar Causing Ileal Obstruction During Treatment with Coca-Cola: Jun Young Lee, Sung Bum Kim, Sang Hoon Lee, Hee Jung Moon, Jong Ryul Eun, Tae Nyeun Kim, Byung Ik Jang; Yeungnam Univ J Med. 2007;24(2 Suppl):S683-688. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S683

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Abstract PDF

Gastric bezoars are usually occur in patients who have undergone gastric surgery and have delayed gastric emptying. Recently, the efficacy of nasogastric lavage or endoscopic injection therapy with Coca-Cola has been reported. But the complication like intestinal obstruction has poorly been reported. We report a case of gastric bezoar causing ileal obstruction during treatment with oral administration and endoscopic injection of Coca-Cola. A 53-year-old man was referred because of epigastric pain for a day. He had a history of subtotal gastrectomy with gastroduodenostomy since 8 years ago. On upper gastrointestinal endoscopy, about 6cm sized, dark-greenish hard bezoar was impacted at gastric antrum and about 3-5cm sized three bezoars were found at body. We injected Coca-Cola into the bezoar through the endoscopy and the patient was instructed to drink four liters of Coca-Cola per day. On the 12^th day of admission, the patient complained severe abdominal pain. On plain abdominal X-ray and CT scan, small bowel obstruction at proximal ileum with bezoar was suspected and exploration was performed. About 4cm sized two bezoars were impacted at proximal ileum, and small bowel resection with primary closure after removal of bezoar was performed. The patient was discharged on the 10th postoperative day without any complication.

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A Case of Huge Gastric Bezoar Removed by Endoscopic Combination Therapy with Coca-Cola Injection
Min Suk Jung, Jang Won Lee, Seung Hyun Lee, Dong Hyun Kim, Sang Hwan Byun, Yeong Muk Kim
Yeungnam University Journal of Medicine.2013; 30(1): 62. CrossRef

Case Report

Gastric Phytobezoar Treated by Oral Intake and Endoscopic Injection of Coca-Cola.: Hee Jung Moon, Sang Hoon Lee, Jun Young Lee, Dong Hee Kim, Ji Eun Lee, Chang Hun Yang, Jong Ryul Eun, Tae Nyeun Kim, Heon Ju Lee, Byung Ik Jang; Yeungnam Univ J Med. 2006;23(2):247-251. Published online December 31, 2006; DOI: https://doi.org/10.12701/yujm.2006.23.2.247

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Abstract PDF

Bezoars are collections or concretions of indigestible foreign material that accumulate and coalesce in the gastrointestinal tract; they usually occur in patients who have undergone gastric surgery and have delayed gastric emptying. Treatment options include dissolution with enzymes, endoscopic fragmentation with removal or aspiration, and surgery. Recently, the efficacy of nasogastric lavage or endoscopic infusion of Coca-Cola for the dissolution of phytobezoar have been reported. We report a case of phytobezoar successfully treated by oral administration and endoscopic injection of Coca-Cola. A 62-year-old woman was referred to Yeungnam University Hospital for epigastric pain. Upper gastrointestinal endoscopy revealed one very large, dark-greenish, solid bezoar in the stomach with gastric ulcer and duodenal bulb deformity. We performed endoscopic injection of Coca-Cola into the bezoar. The patient was instructed to drink four liters of Coca-Cola per day. At endoscopy two days later, the phytobezoar was easily broken into pieces. At endoscopy on the 11th day of admission, the phytobezoar was decreased in size and removed by endoscopic fragmentation with a polypectomy snare. At follow up endoscopy after 13 days, the bezoar was completely dissolved.

Citations

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Systematic review: Coca‐Cola can effectively dissolve gastric phytobezoars as a first‐line treatment
S. D. Ladas, D. Kamberoglou, G. Karamanolis, J. Vlachogiannakos, I. Zouboulis‐Vafiadis
Alimentary Pharmacology & Therapeutics.2013; 37(2): 169. CrossRef

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