A Huge Gastric Bezoar That Was Removed by Endoscopic Combination Therapy with an Argon Plasma and Coca-Cola Injection

아르곤 플라즈마와 코카콜라 주사를 병용하여 내시경으로 분쇄 제거한 거대 위석 1예

  • Kim, Jung-Hoon (Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine) ;
  • Bae, Won-Ki (Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine) ;
  • Lee, Hyoung-Don (Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine) ;
  • Park, Jung-Bok (Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine) ;
  • Kim, Nam-Hoon (Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine) ;
  • Kim, Kyung-Ah (Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine) ;
  • Lee, June-Sung (Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine) ;
  • Moon, Young-Soo (Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine)
  • 김정훈 (인제대학교 의과대학 일산백병원 내과학교실) ;
  • 배원기 (인제대학교 의과대학 일산백병원 내과학교실) ;
  • 이형돈 (인제대학교 의과대학 일산백병원 내과학교실) ;
  • 박정복 (인제대학교 의과대학 일산백병원 내과학교실) ;
  • 김남훈 (인제대학교 의과대학 일산백병원 내과학교실) ;
  • 김경아 (인제대학교 의과대학 일산백병원 내과학교실) ;
  • 이준성 (인제대학교 의과대학 일산백병원 내과학교실) ;
  • 문영수 (인제대학교 의과대학 일산백병원 내과학교실)
  • Received : 2009.12.30
  • Accepted : 2010.03.17
  • Published : 2010.06.30

Abstract

Bezoars are collections or concretions of indigestible foreign material in the gastrointestinal tract. In the past, the most common method for the treatment of bezoar was surgical management. The current treatment methods for bezoars include chemical dissolution and endoscopic lithotripsy using biopsy forceps and, snare, electrohydraulic lithotripsy and laser. Cases of endoscopic fragmentation of gastric bezoars using an argon plasma and dissolution of gastric bezoars with Cola have recently been described, but it took a long time in those cases to remove a bezoar by a single method. Moreover, fragmented, residual bezoar-related complications sometimes occurred. We report here on a case of a 35-year-old man with a $10{\times}8{\times}8$ cm sized huge gastric bezoar that was successfully removed by combination therapy using an argon plasma and Coca-Cola injection. Compared with the previous single method, combination therapy using an argon plasma and Coca-Cola injection shortened the procedure time and reduced the complications related to a fragmented, remaining bezoar.

위석은 소화관 내에서 음식물이나 이물질이 축적되어 응결된 것을 말한다. 위석의 치료로 과거에는 주로 개복술이나 복강경 같은 수술적 치료를 하였으나, 현재는 겸자, 올가미, 전기수압 쇄석기, 레이저, 아르곤 플라즈마를 사용한 내시경적 분쇄 제거를 하거나 소화 효소제, 위장운동 항진제, 콜라를 사용하는 약물적 치료를 한다. 하지만 내시경적 분쇄 제거나 약물적 치료를 단독으로 사용할 경우 시간이 오래 걸리고, 분쇄되어 남은 위석에 의한 합병증도 발생할 수 있다. 저자들은 $10{\times}8{\times}8$ cm 크기의 거대 위석을 아르곤 플라즈마와 코카콜라 주사를 병용하여 내시경으로 분쇄 제거하였다. 한 가지 치료법을 사용한 경우와 비교하여 시술 시간이 짧아졌고 시술 횟수가 줄어들었으며, 분쇄되어 남은 위석에 의한 합병증도 감소하여 문헌고찰과 함께 보고한다.

Keywords

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