[Mechanical lithotripsy of a gastric bezoar]

At the First Medical Clinic of the Faculty Hospital Prague Motol the authors detected during a routine gastroscopic examination of a 71-year-old female patient the presence of a gastric bezoar. The examination was indicated on account of dyspeptic complaints. With regard to the size of the bezoar (50 x 20 mm) the authors decided for mechanical lithotripsy. It proved possible to reduce the concrement during the first session and during subsequent sessions it was broken down to small size and the fragments were eliminated per vias naturales. Several fragments were extracted. Chemical analysis provided evidence of the origin of the concrement in the biliary pathways--the concrement was pure cholesterol. ERCP did not reveal an artificial communication between the biliary system and the stomach or duodenum. It did not prove possible to visualize the gallbladder by ultrasonography. The selected therapeutic procedure was successful.