title: Nonoperative treatment of gastric bezoars using electrohydraulic lithotripsy.
abstract: OBJECTIVE
  Bezoars are collections of indigestible foreign material that are found within the gastrointestinal tract. Nonoperative approaches such as dietary therapy, enzymatic dissolution, and endoscopic removal have been regarded as the mainstays of therapy. The purpose of this paper is to determine the efficacy of electrohydraulic lithotripsy (EHL) as an alternative form of treatment of gastric bezoars.
  
  
  METHODS
  Between July 1988 and May 1996, 11 patients with large gastric bezoars, defined as those greater than 5 cm in diameter, received endoscopic-guided fragmentation using electrohydraulic lithotripsy. Nine of our patients had a history of ingestion of "Pho Pu Zi", (Cordia dichotoma Frost. f.), one of orange pitch, and one of ingestion of persimmon.
  
  
  RESULTS
  The 11 patients in the study underwent EHL for the treatment of their gastric bezoars, with a 100% success rate, which was defined as the lack of residual bezoar seen on post-procedure barium study or endoscopy done 2 days after the procedure. Patients were followed-up clinically for 30-68 months, with seven of the 11 patients undergoing a barium study with no residual bezoar noted. No procedure-related complications were seen, except for pharyngeal pain which was most probably secondary to the placement of the silicon overtube.
  
  
  CONCLUSIONS
  Endoscopically guided electrohydraulic lithotripsy is a safe, highly effective, alternative nonsurgical technique for the treatment of gastric bezoars.
authors.affiliation: Dept. of Internal Medicine, Tainan Municipal Hospital, Taiwan.
authors.forename: J Y
authors.initials: JY
authors.lastname: Kuo
authors.forename: L R
authors.initials: LR
authors.lastname: Mo
authors.forename: C C
authors.initials: CC
authors.lastname: Tsai
authors.forename: C Y
authors.initials: CY
authors.lastname: Chou
authors.forename: R C
authors.initials: RC
authors.lastname: Lin
authors.forename: K K
authors.initials: KK
authors.lastname: Chang
mesh_terms: D000328:Adult; D001630:Bezoars / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D005773:Gastroscopy; D006801:Humans; D008096:Lithotripsy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D012449:Safety; D013270:Stomach; D016896:Treatment Outcome