Abstract
We report a case of successful dissolution therapy with cola for bezoars in the small intestine and the stomach. A 74-year-old man was admitted to our hospital because of nausea and vomiting. Computed tomography (CT) revealed intestinal obstruction caused by a 3-cm mass in the proximal jejunum, and he was diagnosed as having a food-induced ileus. Conservative therapy by placing a long tube into the jejunum was unsuccessful to reduce small bowel obstruction, and another CT examination suggested the mass to be a bezoar. We then performed dissolution therapy with cola injected through the long tube, and with this treatment the bezoar in the small intestine was dissolved and the small bowel obstruction improved rapidly. An upper gastrointestinal endoscopy revealed an additional 7-cm bezoar which remained in the stomach. We performed a direct endoscopic dispersion of cola to this bezoar, and softened it ; we were able to safely fracture it endoscopically. For patients with small bowel obstruction due to bezoars, early diagnosis and surgical treatment are often considered to be necessary, but in the present case, the dissolution therapy with cola-lysis through an ileus tube has been proved to be an effective and less-invasive treatment.
