Journal of the Chinese Medical Association
Volume 71, Issue 1 , Pages 49-52, January 2008

Successful Treatment with a Combination of Endoscopic Injection and Irrigation with Coca Cola for Gastric Bezoar-induced Gastric Outlet Obstruction

  • Chen-Sheng Lin

      Affiliations

    • Division of Gastroenterology, Department of Internal Medicine, Taipei, Taiwan, R.O.C.
    • ,
  • Chun-Fang Tung

      Affiliations

    • Division of Gastroenterology, Department of Internal Medicine, Taipei, Taiwan, R.O.C.
    • Department of Emergency Medicine, Taichung Veterans General Hospital, Taichung, Taipei, Taiwan, R.O.C.
    • National Yang Ming University School of Medicine, Taipei, Taiwan, R.O.C.
    • Corresponding Author InformationCorrespondence to: Dr Chun-Fang Tung, Department of Emergency Medicine, Taichung Veterans General Hospital, 160, Section 3, Chung-Kang Road, Taichung 407, Taiwan, R.O.C
    • ,
  • Yen-Chun Peng

      Affiliations

    • Division of Gastroenterology, Department of Internal Medicine, Taipei, Taiwan, R.O.C.
    • Department of Emergency Medicine, Taichung Veterans General Hospital, Taichung, Taipei, Taiwan, R.O.C.
    • National Yang Ming University School of Medicine, Taipei, Taiwan, R.O.C.
    • ,
  • Wei-Keung Chow

      Affiliations

    • Division of Gastroenterology, Department of Internal Medicine, Taipei, Taiwan, R.O.C.
    • ,
  • Chi-Sen Chang

      Affiliations

    • Division of Gastroenterology, Department of Internal Medicine, Taipei, Taiwan, R.O.C.
    • ,
  • Wei-Hsiung Hu

      Affiliations

    • Department of Emergency Medicine, Taichung Veterans General Hospital, Taichung, Taipei, Taiwan, R.O.C.

Received 6 June 2007; accepted 7 September 2007.

We report a case of gastric bezoar-induced gastric outlet obstruction that was successfully treated with a combination of endoscopic injection and irrigation with Coca Cola. A 73-year-old diabetic woman had a history of perforated peptic ulcer and had received pyloroplasty more than 20 years previously. She had been ingesting Pho Pu Zi (Cordia dichotoma Forst. f.) as an appetizer for 1 month. She presented with epigastric pain, nausea, and vomiting. Upper gastrointestinal endoscopy, performed at a local hospital, showed 2 gastric bezoars in the stomach, and 1 of them impacted at the pylorus. She was referred to our emergency department for removal of the gastric bezoars that were suspected to be causing gastric outlet obstruction. All attempts at endoscopic removal using a polypectomy snare, biopsy forceps and Dormia basket failed. We then injected Coca Cola directly into the bezoar mass, followed by irrigation with Coca Cola. Follow-up endoscopy was performed the next day, which revealed that the gastric bezoars had dissolved spontaneously.

Key Words:  bezoars , Coca Cola , endoscopy , gastric outlet obstruction

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PII: S1726-4901(08)70073-X

doi:10.1016/S1726-4901(08)70073-X

Journal of the Chinese Medical Association
Volume 71, Issue 1 , Pages 49-52, January 2008

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