A safe treatment option for esophageal bezoars

Sheraz Yaqub; Muhammad Shafique; Erik Kjæstad; Yngve Thorsen; Erik S Lie; Vegard Dahl; Njål Bakka; Ola Røkke

doi:10.1016/j.ijscr.2012.04.008

A safe treatment option for esophageal bezoars

Int J Surg Case Rep. 2012;3(8):366-7. doi: 10.1016/j.ijscr.2012.04.008. Epub 2012 Apr 24.

Authors

Sheraz Yaqub¹, Muhammad Shafique, Erik Kjæstad, Yngve Thorsen, Erik S Lie, Vegard Dahl, Njål Bakka, Ola Røkke

Affiliation

¹ Department of Gastrointestinal Surgery, Oslo University Hospital, Oslo, Norway; Department of Gastrointestinal Surgery, Akershus University Hospital, 1478 Lorenskog, Norway.

Abstract

Introduction: Bezoar in the esophagus is a rare condition and associated with structural or functional abnormalities of the esophagus. Endoscopy is the main tool for diagnosis and treatment for bezoar in the esophagus.

Presentation of case: Here we present a case where an endoscopic evacuation of an esophageal bezoar was unsuccessful. We treated the bezoar through a nasogastric tube using a cocktail composed of pancreatic enzymes dissolved in Coca-Cola.

Discussion: Endoscopy is regarded as the mainstay for the diagnosis and treatment of esophageal bezoars. However, when this approach fails, other treatment options include dissolution therapy, and surgical exploration and removal of the bezoar. Surgical removal of an esophageal bezoar is associated with a high risk of morbidity and mortality. We advocate that dissolving therapy should be the first choice of treatment when endoscopic evacuation is not possible.

Conclusion: This is the first report describing a successful treatment of an esophageal bezoar with a cocktail of Coca-Cola and pancreatic enzymes. It is an effective, inexpensive, and worldwide available treatment and should be considered when endoscopic evacuation fails.