A case of a huge gastric bezoar treated with an endoscopic Coca-cola injection and an Argon plasma beam

코카콜라 내시경적 주입법과 아르곤 플라스마 빔을 이용한 위석의 치료 1예

Bezoars are persistent concretions of indigestible materials found in the stomach. They can cause mucosal ulceration or wall perforation, gastritis, gastric outlet obstruction, or gastrointestinal bleeding. With the significant development of endoscopic techniques, many authors have reported the removal of bezoars using methods such as endoscopic mechanical lithotomy and chemical dissolution however, the outcomes differ according to the treatment method. We report a case treated successfully with an endoscopic Coca-cola injection and an argon plasma beam for 90 minutes. A 61-year-old man was admitted with a 4-day history of upper abdominal pain. A bezoar was detected by upper gastrointestinal endoscopy. The bezoar ($10{\times}8{\times}6$ cm) was dark brown in color and extremely hard. Attemptat endoscopic removal using a polypectomy snare failed. We then injected Coca-cola directly into the bezoar mass and sprayed it with an Argon plasma beam. Ninety minutes later, the bezoar was broken into pieces and removed. The bezoar was absent at the follow up endoscopy 2 weeks later.

크기가 크고 단단한 위석($10{\times}8{\times}6$ cm)에 내시경적인 방법으로 주입기를 통해 코카콜라 30 mL를 여러 군데 주입하였고, 한 시간 후 아르곤 플라스마 빔을 조사하여 위석을 절개 및 파쇄하였다. 이 절단면에 다시 코카콜라를 주입하였고, 아르곤 플라스마 소작기, 용종절제술 올가미, 쇄석기 바스켓을 이용하여 위석을 반복적으로 분쇄하였다. 이와 같은 병합요법으로 기존에 수일에 걸쳐 제거되었던 위석이 90분 내에 안전하게 제거되어 증례를 보고하는 바이다.