NYMC Faculty Publications
A Case of Megaesophagus Secondary to a Massive Phytobezoar in a Patient With Achalasia
Author Type(s)
Faculty, Resident/Fellow
Journal Title
Cureus
First Page
e23061
Document Type
Article
Publication Date
3-1-2022
Department
Medicine
Abstract
Bezoar is a rare entity that is composed of indigested foreign material and is most commonly seen in the stomach. Phytobezoars are the most common type of bezoars and are composed of indigestible cellulose and lignin from fruits and vegetables. We present a unique case of esophageal phytobezoar, which was seen in a patient with long-standing achalasia. The patient presented to the gastroenterology clinic complaining of decreased appetite as she had worsening dysphagia, weight loss, vomiting on eating food. An endoscopy revealed a large phytobezoar that was extending along the whole length of the esophagus. There was stenosis at the gastroesophageal (GE) junction. The phytobezoar was dissolved with carbonated soda lavage and the remainder of the phytobezoar was fragmented with water irrigation and rescue net via the endoscope and fragments were retrieved. Botulinum was injected at the GE junction in all four quadrants which resulted in a relaxation of the stenosis. Untreated long-standing esophageal phytobezoars can lead to life-threatening complications like perforation. Endoscopic modalities with carbonated soda lavage is an efficacious mode of treatment. Surgical interventions are recommended in case of endoscopic modality failure.
Recommended Citation
Hashmi, S. S., Dimino, J., Shady, A., Harley, J., & Maranino, A. (2022). A Case of Megaesophagus Secondary to a Massive Phytobezoar in a Patient With Achalasia. Cureus, 14 (3), e23061. https://doi.org/10.7759/cureus.23061
