Matsuoka Ryo, Masuda Saori, Fujita Satoshi, Akiyama Naoe
Department of Pediatrics Fuji City General Hospital Shizuoka Japan.
Department of Pediatrics The Jikei Medical School of Medicine Tokyo Japan.
DEN Open. 2023 Sep 25;4(1):e283. doi: 10.1002/deo2.283. eCollection 2024 Apr.
Trichobezoars (hair bezoars) are primarily observed in adolescent girls who pull their hair followed by its ingestion. Endoscopic removal of trichobezoars is challenging, and these masses often require surgical removal. Recently, although it has been reported that Coca-Cola could effectively dissolve persimmon phytobezoars, it was ineffective in dissolving trichobezoars. We report a case in which Coca-Cola was directly injected into a trichobezoar followed by successful endoscopic removal of the mass. A 9-year-old girl visited our hospital with abdominal pain and nausea, wherein abdominal radiography revealed a mass in the stomach. Her mother witnessed her pulling and ingesting her hair 6 months previously. An upper endoscopy was performed for diagnosis of the trichobezoar. Endoscopic removal of the mass was performed under general anesthesia following oral administration of Coca-Cola at a dose of 100 mL thrice a day for 10 days. Initially, we attempted endoscopic extraction using grasping forceps and a radiofrequency snare. However, the bezoar could not be fragmented and did not pass through the cardia. Thus, Coca-Cola was injected directly into the bezoar using a local injection needle, which facilitated the separation of the bezoar and allowed the grasping forceps to fragment it to a size that could pass through the cardia. Owing to the large size of the bezoar, we could remove 180 g of it without complications. The patient received psychological counseling after the procedure, to prevent recurrence. In conclusion, direct injection of Coca-Cola was effective in the complete endoscopic removal of trichobezoars.
毛发石（毛粪石）主要见于有拔毛癖并随后吞食毛发的青春期女孩。内镜下取出毛发石具有挑战性，这些团块通常需要手术切除。最近，尽管有报道称可口可乐可有效溶解柿植物性胃石，但对溶解毛发石无效。我们报告了一例将可口可乐直接注入毛发石后成功通过内镜取出团块的病例。一名9岁女孩因腹痛和恶心前来我院就诊，腹部X线检查显示胃内有一个团块。她的母亲目睹她在6个月前有拔毛并吞食毛发的行为。为诊断毛发石进行了上消化道内镜检查。在全身麻醉下，先让患儿每天口服100 mL可口可乐，共10天，之后进行内镜下团块取出术。最初，我们尝试用抓钳和射频圈套器进行内镜下取出。然而，粪石无法破碎，也不能通过贲门。因此，我们用局部注射针将可口可乐直接注入粪石，这有助于粪石分离，并使抓钳能够将其破碎成可通过贲门的大小。由于粪石体积较大，我们成功取出了180 g且未发生并发症。术后患者接受了心理咨询，以防止复发。总之，直接注射可口可乐对于内镜下完全取出毛发石是有效的。
