Lee Kang Won, Ha Young Woo, Lee Jae Min, Choe Jung Wan, Hyun Jong Jin, Lee Hong Sik
Department of Internal Medicine, Division of Gastroenterology and Hepatology, Korea University College of Medicine, Seoul, Republic of Korea.
J Minim Access Surg. 2023 Jul-Sep;19(3):437-439. doi: 10.4103/jmas.jmas_30_22.
Bezoar without gastrointestinal surgical history occurring simultaneously in the gastric and duodenal lumen is very rare. We report a case of acute pancreatitis due to duodenal obstruction caused by two large bezoars. Two large bezoars were detected in the gastric and duodenal lumen, respectively, on abdominal computed tomography (CT) scan and oesophagogastroduodenoscopy images. Bezoars were crushed and removed using endoscopic devices such as trapezoid basket and lithotripsy handle. After removal of bezoars, blood tests and CT follow-up tests confirmed improvement. In the case of bezoar, which causes duodenal obstruction, it is difficult to administer coke for dissolution, and if it is difficult to perform surgical approach due to old age, an endoscopic treatment using mechanical lithotripsy devices can be an alternative option.
在无胃肠道手术史的情况下，胃和十二指肠腔内同时出现胃石极为罕见。我们报告一例由两颗大胃石导致十二指肠梗阻引起的急性胰腺炎病例。腹部计算机断层扫描（CT）和食管胃十二指肠镜检查图像显示，胃和十二指肠腔内分别发现两颗大胃石。使用梯形篮和碎石手柄等内镜设备将胃石粉碎并取出。胃石取出后，血液检查和CT随访检查证实病情有所改善。对于导致十二指肠梗阻的胃石，难以用可乐进行溶解治疗，并且如果因患者年龄较大而难以进行手术治疗，那么使用机械碎石设备进行内镜治疗可能是一种替代选择。
