Hashmi Syed Salman Hamid, Dimino Jennifer, Shady Ahmed, Harley Jennifer, Maranino Ashley
Internal Medicine, NYU (New York University) Langone/Woodhull Hospital, New York, USA.
Gastroenterology, New York Medical College, Metropolitan Hospital Center, New York, USA.
Cureus. 2022 Mar 11;14(3):e23061. doi: 10.7759/cureus.23061. eCollection 2022 Mar.
Bezoar is a rare entity that is composed of indigested foreign material and is most commonly seen in the stomach. Phytobezoars are the most common type of bezoars and are composed of indigestible cellulose and lignin from fruits and vegetables. We present a unique case of esophageal phytobezoar, which was seen in a patient with long-standing achalasia. The patient presented to the gastroenterology clinic complaining of decreased appetite as she had worsening dysphagia, weight loss, vomiting on eating food. An endoscopy revealed a large phytobezoar that was extending along the whole length of the esophagus. There was stenosis at the gastroesophageal (GE) junction. The phytobezoar was dissolved with carbonated soda lavage and the remainder of the phytobezoar was fragmented with water irrigation and rescue net via the endoscope and fragments were retrieved. Botulinum was injected at the GE junction in all four quadrants which resulted in a relaxation of the stenosis. Untreated long-standing esophageal phytobezoars can lead to life-threatening complications like perforation. Endoscopic modalities with carbonated soda lavage is an efficacious mode of treatment. Surgical interventions are recommended in case of endoscopic modality failure.
胃石是一种罕见的由未消化的异物组成的物质，最常见于胃内。植物性胃石是胃石最常见的类型，由水果和蔬菜中不可消化的纤维素和木质素组成。我们报告一例独特的食管植物性胃石病例，该病例见于一名患有长期贲门失弛缓症的患者。该患者因吞咽困难加重、体重减轻、进食时呕吐而食欲下降，前往胃肠病诊所就诊。内镜检查发现一个巨大的植物性胃石沿食管全长延伸。胃食管交界处存在狭窄。通过用碳酸苏打水灌洗溶解胃石，其余的胃石通过内镜用水冲洗和抢救网破碎，并取出碎片。在胃食管交界处的四个象限均注射了肉毒杆菌，导致狭窄松弛。未经治疗的长期食管植物性胃石可导致穿孔等危及生命的并发症。碳酸苏打水灌洗的内镜治疗方法是一种有效的治疗方式。如果内镜治疗失败，建议进行手术干预。
