[Skip to Content]
[Skip to Content Landing]
September 2, 1974

Endoscopic Enzymatic Dissolution: Nonsurgical Therapy for Gastric Phytobezoars

Author Affiliations

From the Gastrointestinal Endoscopy Division, Colony Medical Group (Dr. Davis), and the Crawford W. Long Memorial Hospital (Dr. Faruqui), Atlanta.

JAMA. 1974;229(10):1332-1333. doi:10.1001/jama.1974.03230480048029

FIBEROPTIC gastroscopies are largely responsible for the sharp increase in the diagnosis of postoperative gastric phytobezoars. The latter have been noted as a postoperative complication in 14% of all gastrectomies in one series.1 In our recent experience with five documented cases in 1973, we have had surprisingly good results with nonsurgical management.

Our five patients, two men and three women, ranged in age from 42 to 57 years. Four of the five were edentulous. They gave a history of ingesting citrus fruits, apple cores, and apple peels. All had undergone partial gastrectomy and vagotomy (Billroth II) from six weeks to 11 years before admission. All were admitted for episodes of epigastric discomfort with associated nausea and vomiting. Upper-gastrointestinal roentgenographic series were done on the patients before admission (Fig 1), and gastric bezoar was originally suspected in only one of them. In the other four, the roentgenograms were thought to