Year 2026 / Volume 118 / Number 1
Letter
A giant luminal bezoar treated by mechanical lithotripsy using a yellow zebra guide wire

59-60

DOI: 10.17235/reed.2024.10880/2024

Chen Yuan, Fang Wang, Youhong Cao,

Abstract
Endoscopic fragmentation or removement of gastric bezoar is the simplest, most cost-effective approach, while the traditional endoscopic device include foreign body forceps, polypectomy snare, laser lithotripsy, and electrohydraulic lithotripsy. For bezoar < 3 cm, traditional snares are preferred. But for some giant or hard bezoars, traditional snares are too easily deformed to be used continuously and can be embedded in the bezoar causing direct damage to the stomach , Therefore, a handy and effective snare-like approach is needed, especially for elderly patients who have a high surgical risk. The lithotriptic device should be evaluated according to the size and texture of the gastroliths before lithotripsy. For some relatively hard gastroliths, which are easy to damage the endoscope, the use of transparent caps is a wise choice, which can protect the mirror body well. In this case, the bezoar was oversized (6 cm) and traditional snare was failed to capture the bezoar. Laser lithotripsy and electrohydraulic lithotripsy were lacking supplies and were not promptly available in our hospital. Therefore, we chose a yellow zebra guide wire to make this large snare for lithotripsy completely and removed with the assistance of gastric bezoar basket. The case highlights the importance of regular endoscopic instruments.
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References
Parsi S, Rivera C, Vargas J, Silberstein MW. Laparoscopic-assisted extirpation of a phytobezoar causing small bowel obstruction after Roux-en-Y laparoscopic gastric bypass. The American surgeon. 2013;79:E93-5.
Iwamuro M, Okada H, Matsueda K, Inaba T, Kusumoto C, Imagawa A, et al. Review of the diagnosis and management of gastrointestinal bezoars. World journal of gastrointestinal endoscopy. 2015;7:336-45.
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Yuan C, Wang F, Cao Y. A giant luminal bezoar treated by mechanical lithotripsy using a yellow zebra guide wire. 10880/2024


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Publication history

Received: 21/10/2024

Accepted: 27/10/2024

Online First: 12/11/2024

Published: 14/01/2026

Article Online First time: 22 days

Article editing time: 450 days


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