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Gastroenterology Insights
Volume 7
Issue 1
10.4081/gi.2016.6808
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Gastroenterology Insights is published by MDPI from Volume 11 Issue 1 (2020). Previous articles were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence, and they are hosted by MDPI on mdpi.com as a courtesy and upon agreement with PAGEPress.
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Case Report

A Giant Gastric Bezoar in Billroth II Stomach: A Case Report on Successful Endoscopic Removal via Repeated Fragmentation and Dissolution Technique Negating the Need for Surgical Intervention

by
Jin Yu Chieng
1,*,
Shiaw Hooi Ho
2 and
Khean Lee Goh
2
1
Department of Medicine, Faculty of Medicine and Health Science, Putra University of Malaysia, Selangor, Malaysia
2
Department of Medicine, University of Malaya, Kuala Lumpur, Malaysia
*
Author to whom correspondence should be addressed.
Gastroenterol. Insights 2016, 7(1), 6808; https://doi.org/10.4081/gi.2016.6808
Submission received: 29 July 2016 / Accepted: 12 August 2016 / Published: 19 August 2016

Abstract

A 76-year-old gentleman presented with anemia. He had a history of perforated duodenal ulcer six years ago, with Billroth II repair performed. A large gastric bezoar (8×6 cm2) with a clean base ulcer at the anastomotic junction was found during the initial oesophago- gastro-duodenoscopy (OGDS). Rapid urease test was negative. He presented with melena during the subsequent follow up (OGDS showed a Forrest Ib prepylori ulcer). We have successfully removed the gastric bezoar with dissolution therapy initially (injection of cokecola into the bezoar, followed by drinking 325 mL Coca-ColaTM twice daily), followed by four attempts of OGDS with endoscopic fragmentation. Histopathology reported as degenerated vegetable matter, acellular debris mixed with scattered fungal and bacterial colonies, which was compatible with bezoar. Follow-up OGDS showed complete clearance of the bezoar. Coca-ColaTM ingestion should be considered as initial treatment as it is non-invasive, and it enables further successful endoscopic fragmentation.
Keywords: Anemia; bezoar; Oesophago-gastro-duodenoscopy; ulcer Anemia; bezoar; Oesophago-gastro-duodenoscopy; ulcer

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MDPI and ACS Style

Chieng, J.Y.; Ho, S.H.; Goh, K.L. A Giant Gastric Bezoar in Billroth II Stomach: A Case Report on Successful Endoscopic Removal via Repeated Fragmentation and Dissolution Technique Negating the Need for Surgical Intervention. Gastroenterol. Insights 2016, 7, 6808. https://doi.org/10.4081/gi.2016.6808

AMA Style

Chieng JY, Ho SH, Goh KL. A Giant Gastric Bezoar in Billroth II Stomach: A Case Report on Successful Endoscopic Removal via Repeated Fragmentation and Dissolution Technique Negating the Need for Surgical Intervention. Gastroenterology Insights. 2016; 7(1):6808. https://doi.org/10.4081/gi.2016.6808

Chicago/Turabian Style

Chieng, Jin Yu, Shiaw Hooi Ho, and Khean Lee Goh. 2016. "A Giant Gastric Bezoar in Billroth II Stomach: A Case Report on Successful Endoscopic Removal via Repeated Fragmentation and Dissolution Technique Negating the Need for Surgical Intervention" Gastroenterology Insights 7, no. 1: 6808. https://doi.org/10.4081/gi.2016.6808

APA Style

Chieng, J. Y., Ho, S. H., & Goh, K. L. (2016). A Giant Gastric Bezoar in Billroth II Stomach: A Case Report on Successful Endoscopic Removal via Repeated Fragmentation and Dissolution Technique Negating the Need for Surgical Intervention. Gastroenterology Insights, 7(1), 6808. https://doi.org/10.4081/gi.2016.6808

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