Department of Gastroenterology, Hachinohe City Hospital, Japan.
Division of Gastroenterology, Tohoku University Graduate School of Medicine, Japan.
Intern Med. 2023 Oct 15;62(20):2965-2969. doi: 10.2169/internalmedicine.1582-23. Epub 2023 Mar 8.
An 87-year-old woman visited her primary-care doctor because of nausea and epigastric pain. Esophagogastroduodenoscopy (EGD) revealed a giant bezoar in her stomach. She was referred to our hospital after carbonated beverage dissolution proved ineffective and underwent endoscopic mechanical crushing. After crushing, the symptoms disappeared, and she began eating. Later, however, the crushed fragments reassembled in the duodenal bulb and caused intestinal obstruction. The patient underwent emergency EGD for crushing once more, and all of the fragments were extracted from the body. This case highlights the need for bezoars to be removed from the body after crushing in order to avoid reassembly.
一位 87 岁女性因恶心和上腹痛就诊于她的初级保健医生。食管胃十二指肠镜(EGD)显示她的胃中有一个巨大的胃石。在碳酸饮料溶解无效并进行内镜机械粉碎后,她被转至我们医院。粉碎后,症状消失,她开始进食。然而,后来粉碎的碎片在十二指肠球部重新聚集并导致肠梗阻。患者再次紧急进行 EGD 粉碎,所有碎片都从体内取出。本病例强调了粉碎后需要将胃石从体内取出,以避免重新聚集。