Gastric phytobezoar: an endoscopic technique for removal.

Gastric bezoars, especially those of the phytobezoar type, are a rare sequela of gastroduodenal surgery or other uncommon circumstances. When they produce symptoms, removal is always necessary. In the past, treatment has shifted from surgical to non-surgical intervention, of which gastric lavage and/or slow enzymatic dissolution have been attempted. A safe, simple and rapid endoscopic method for the removal of the bezoar has previously been reported by 3 authors. With our two patients there are now ten cases of successful fragmentation of phytobezoars by this technique using a pulsating jet of water through the endoscope. This success recommends the procedure as treatment of choice, and it should be used more widely.