Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. May 6, 2021; 9(13): 3114-3119
Published online May 6, 2021. doi: 10.12998/wjcc.v9.i13.3114
Acute pancreatitis and small bowel obstruction caused by a migratory gastric bezoar after dissolution therapy: A case report
Ting-Ting Wang, Jia-Jun He, Jun Liu, Wei-Wei Chen, Chao-Wu Chen
Ting-Ting Wang, Jia-Jun He, Department of Gastroenterology, The First Clinical Medical College, Dalian Medical University, Dalian 116044, Liaoning Province, China
Jun Liu, Wei-Wei Chen, Chao-Wu Chen, Endoscopy Center, Department of Gastroenterology, Clinical Medical College, Yangzhou University, Yangzhou 225009, Jiangsu Province, China
Author contributions: Wang TT was the main author of this article; He JJ modified the manuscript; Liu J and Chen WW contributed to manuscript drafting; Chen CW were responsible for revising the manuscript for important intellectual content; All authors issued final approval for the version to be submitted.
Informed consent statement: Written informed consent was obtained from the patient for publication of this case report.
Conflict-of-interest statement: The authors declared that they have no conflicts of interest regarding this work.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Chao-Wu Chen, MD, Associate Chief Physician, Endoscopy Center, Department of Gastroenterology, Clinical Medical College, Yangzhou University, No. 88 South University Ave, Yangzhou 225009, Jiangsu Province, China. sbyy_ccw@163.com
Received: November 15, 2020
Peer-review started: November 15, 2020
First decision: January 27, 2021
Revised: February 8, 2021
Accepted: March 3, 2021
Article in press: March 3, 2021
Published online: May 6, 2021
Processing time: 158 Days and 10 Hours
Abstract
BACKGROUND

Bezoars are conglomerates of indigestible foreign material that can be found in the gastrointestinal tract. Gastric ulcer, gastrointestinal perforation, and intestinal obstruction are the main complications. Acute pancreatitis secondary to bezoar is rare. Here, we present a rare case of a migratory gastric bezoar complicated by acute pancreatitis and small bowel obstruction after dissolution therapy.

CASE SUMMARY

A-65-year-old woman underwent gastroscopy because of epigastric pain, which revealed a huge bezoar and a gastric ulcer 10 d prior. The patient was discharged with a prescription of drinking 1 L Coca-Cola daily for 6 d, without repeat gastroscopy. However, she suddenly developed epigastric pain, nausea and vomiting for 3 d. Abdominal computed tomography (CT) revealed mild inflammation of the pancreas. Magnetic resonance cholangiopancreatography showed no abnormalities in the pancreatic duct or common bile duct. The nasogastric tube still showed drainage of more than 1.6 L of dark fluid each day after symptomatic treatment. Abdominal CT re-examination suggested intestinal obstruction. Esophagogastroduodenoscopy revealed a huge yellowish hard mass in the jejunal lumen, and we used the basket and net to fragment the bezoar. She was discharged with a good outcome.

CONCLUSION

Endoscopic therapy is the first choice for gastric bezoars. When mechanical disintegration cannot be achieved, timing of repeat endoscopy is important during Coca-Cola dissolution therapy.

Keywords: Bezoar; Intestinal obstruction; Acute pancreatitis; Dissolution therapy; Endoscopy; Case report

Core Tip: Coca-Cola dissolution therapy is as an easy, safe, and cost-effective option for gastric bezoars. Acute pancreatitis and small intestinal obstruction secondary to a migratory gastric bezoar during Coca-Cola dissolution therapy has not been previously reported. Here, we report a case of acute pancreatitis and small bowel obstruction caused by a migratory gastric bezoar after dissolution therapy.