Clinical applications of carbonated beverages: A case report of large gastric phytobezoar complicated by acute pancreatitis

碳酸饮料的临床应用:一例巨大胃植物石并发急性胰腺炎的病例报告

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Abstract

RATIONALE: Phytobezoars are foreign bodies that form in the gastrointestinal tract as a result of accumulated ingested substances. Phytobezoars and acute pancreatitis occur concomitantly are rare, presenting diagnostic and therapeutic challenges for clinicians. Endoscopic mechanical lithotripsy with a single-use snare was utilized in this case; the treatment effect was suboptimal, and oral sodium bicarbonate and carbonated beverages are simple and effective non-surgical treatments for phytobezoars. PATIENT CONCERNS: A 65-year-old woman was hospitalized at our facility after experiencing abdominal pain for half a day due to eating persimmons. The diagnosis of phytobezoar-induced pancreatitis and gastric ulcers was confirmed by clinical examination. Most clinical symptoms have improved with comprehensive therapeutic strategies. DIAGNOSES: The final diagnosis was gastric phytobezoar, acute pancreatitis, and gastric ulcers. INTERVENTIONS: Including anti-infection measures, inhibiting gastric acid secretion, safeguarding the gastric mucosa, inhibiting pancreatic enzyme activity, minimally invasive endoscopic procedures, and drinking carbonated beverages (Coca-Cola). OUTCOMES: The majority of clinical symptoms improved with comprehensive therapeutic strategies, and a follow-up gastroscope after 4 days showed that the phytobezoar had disappeared. At the 14-day follow-up, the patient felt well and did not experience any symptoms. LESSONS: This case presents ideas and methods for treating phytobezoars in patients with multimorbidity and is intended to serve as a reference for the clinical diagnosis and treatment of similar situations.

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