4.2 Article

Tannin-phytobezoars with Gastric Outlet Obstruction Treated by Dissolution with Administration and Endoscopic Injection of Coca-Cola®, Endoscopic Crushing, and Removal (with Video)

Journal

INTERNAL MEDICINE
Volume 61, Issue 3, Pages 335-338

Publisher

JAPAN SOC INTERNAL MEDICINE
DOI: 10.2169/internalmedicine.8090-21

Keywords

gastric bezoars; tannin; phytobezoars; endoscopic surgery; Coca-Cola (R); gastric outlet obstruction

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We report a rare case of tannin-phytobezoars that were endoscopically removed with the administration and injection of Coca-Cola (R). The patient drank Coca-Cola (R) for 4 days to soften the bezoars, and they were then crushed and removed using endoscopic instruments.
A 77-year-old man complained of postmeal vomiting and sustained general fatigue. An abdominal computed tomography scan showed massive gastric expansion and fluid storage. Gastroscopy revealed four gastric bezoars that were considered to have caused pyloric ring obstruction. The patient was asked to drink 500 mL per day of Coca-Cola (R) for 4 days. On the fourth day, we performed endoscopic crushing and removal by injecting Coca-Cola (R), cutting the softened bezoar with endoscopic snares, and collecting the pieces with endoscopic nets. We herein report (with a video presentation) a rare case of tannin-phytobezoars endoscopically removed with the administration and injection of Coca-Cola (R).

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