Abstract
Background and Study Aims: After the first gastroscopic removal of a bezoar by McKechne in 1972, different endoscopic
methods have been reported including a water jet, forceps, snare, and basket. Huge
and solid bezoars, however, are still a problem. We report on our experience in fragmenting
huge, solid bezoars using a modified needle-knife (bezotome) and a modified mechanical
lithotriptor (bezotriptor).
Patients and Methods: Over a period of 14 months (October 1994 to December 1995), a total of 15 patients
(ten male, five female, median age 41 years) with 17 gastric bezoars and one esophageal
bezoar, treated endoscopically, were included in the study. A monopolar diathermy
knife with a 15 mm needle (bezotome) was used for trichobezoars. For diospyrobezoars
we need a bezotriptor.
Results: All 18 bezoars, from 4 × 3 × 3 cm to 10 × 8 × 8 cm in size, were successfully fragmented,
ten in one session and eight in two sessions. Complete clearance of the upper digestive
tract was achieved at the latest three days after the treatment. There were no complications.
Conclusion: Bezotome and bezotriptor are useful endoscopic devices to disintegrate huge, hard
bezoars and achieve complete clearance.
