Tannin-phytobezoars with Gastric Outlet Obstruction Treated by Dissolution with Administration and Endoscopic Injection of Coca-Cola®, Endoscopic Crushing, and Removal (with Video)

Kazuhiro Ota; Shimpei Kawaguchi; Taro Iwatsubo; Shinya Nishida; Hironori Tanaka; Yosuke Mori; Noriyuki Nakajima; Akitoshi Hakoda; Noriaki Sugawara; Yuichi Kojima; Toshihisa Takeuchi; Masahiro Sakaguchi; Kazuhide Higuchi

doi:10.2169/internalmedicine.8090-21

CASE REPORTS

Tannin-phytobezoars with Gastric Outlet Obstruction Treated by Dissolution with Administration and Endoscopic Injection of Coca-Cola^®, Endoscopic Crushing, and Removal (with Video)

Kazuhiro Ota, Shimpei Kawaguchi, Taro Iwatsubo, Shinya Nishida, Hironori Tanaka, Yosuke Mori, Noriyuki Nakajima, Akitoshi Hakoda, Noriaki Sugawara, Yuichi Kojima, Toshihisa Takeuchi, Masahiro Sakaguchi, Kazuhide Higuchi

Author information

Kazuhiro Ota
Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Japan
Shimpei Kawaguchi
Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Japan
Taro Iwatsubo
Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Japan
Shinya Nishida
Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Japan
Hironori Tanaka
Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Japan
Yosuke Mori
Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Japan
Noriyuki Nakajima
Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Japan
Akitoshi Hakoda
Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Japan
Noriaki Sugawara
Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Japan
Yuichi Kojima
Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Japan
Toshihisa Takeuchi
Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Japan
Masahiro Sakaguchi
Department of Gastroenterology, Toyonaka Keijinkai Hospital, Japan
Kazuhide Higuchi
Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Japan

Keywords: gastric bezoars, tannin, phytobezoars, endoscopic surgery, Coca-Cola^®, gastric outlet obstruction

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Supplementary material

2022 Volume 61 Issue 3 Pages 335-338

DOI https://doi.org/10.2169/internalmedicine.8090-21

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Details

Abstract

A 77-year-old man complained of postmeal vomiting and sustained general fatigue. An abdominal computed tomography scan showed massive gastric expansion and fluid storage. Gastroscopy revealed four gastric bezoars that were considered to have caused pyloric ring obstruction. The patient was asked to drink 500 mL per day of Coca-Cola^® for 4 days. On the fourth day, we performed endoscopic crushing and removal by injecting Coca-Cola^®, cutting the softened bezoar with endoscopic snares, and collecting the pieces with endoscopic nets. We herein report (with a video presentation) a rare case of tannin-phytobezoars endoscopically removed with the administration and injection of Coca-Cola^®.

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