The Endoscopic Removal of a Gastric Bezoar Made of Sodium Zirconium Cyclosilicate Hydrate
Abstract
Sodium zirconium cyclosilicate hydrate (SZC) is a novel potassium binder that can be administered either orally or via nasogastric tubes. We report the case of a 77-year-old woman who developed a 37-mm gastric bezoar after nasogastric SZC administration during intensive care for acute adrenal insufficiency. Endoscopic removal was performed, and the analysis confirmed that the SZC was the primary constituent. Impaired gastric motility, acidic gastric environment, and limited hydration are likely contributors. This case highlights the potential for SZC-induced gastric bezoar formation in critically ill patients, and underscores the importance of imaging monitoring, careful gastrointestinal management, and the awareness of this potential complication during SZC therapy.
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BibTeX
@article{yamauchi2026endoscopic,
title = {{The Endoscopic Removal of a Gastric Bezoar Made of Sodium Zirconium Cyclosilicate Hydrate}},
author = {Katsuma Yamauchi and Aya Kitae and Masayuki Hara and Seiya Sugeta and Keiji Yoneda and Tomohiro Ueda and Kazuhiro Tsuji and Yasutaka Morimoto and Akiko Shibuya and Tomoyuki Ohno and Tomoki Nakajima and Norimasa Yoshida and Miyuki Kitade and Hiroyuki Inagake and Nozomi Yoshioka and Emiko Wada and Hikaru Takayasu and Miki Ueda and Risa Ueno and Yoshito Itoh},
journal = {Internal Medicine},
year = {2026},
month = sep,
doi = {10.2169/internalmedicine.6743-25},
url = {https://www.jstage.jst.go.jp/article/internalmedicine/65/17/65_6743-25/_article},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - The Endoscopic Removal of a Gastric Bezoar Made of Sodium Zirconium Cyclosilicate Hydrate
AU - Katsuma Yamauchi
AU - Aya Kitae
AU - Masayuki Hara
AU - Seiya Sugeta
AU - Keiji Yoneda
AU - Tomohiro Ueda
AU - Kazuhiro Tsuji
AU - Yasutaka Morimoto
AU - Akiko Shibuya
AU - Tomoyuki Ohno
AU - Tomoki Nakajima
AU - Norimasa Yoshida
AU - Miyuki Kitade
AU - Hiroyuki Inagake
AU - Nozomi Yoshioka
AU - Emiko Wada
AU - Hikaru Takayasu
AU - Miki Ueda
AU - Risa Ueno
AU - Yoshito Itoh
PY - 2026
DA - 2026/09/01
JO - Internal Medicine
DO - 10.2169/internalmedicine.6743-25
UR - https://www.jstage.jst.go.jp/article/internalmedicine/65/17/65_6743-25/_article
AB - Sodium zirconium cyclosilicate hydrate (SZC) is a novel potassium binder that can be administered either orally or via nasogastric tubes. We report the case of a 77-year-old woman who developed a 37-mm gastric bezoar after nasogastric SZC administration during intensive care for acute adrenal insufficiency. Endoscopic removal was performed, and the analysis confirmed that the SZC was the primary constituent. Impaired gastric motility, acidic gastric environment, and limited hydration are likely contributors. This case highlights the potential for SZC-induced gastric bezoar formation in critically ill patients, and underscores the importance of imaging monitoring, careful gastrointestinal management, and the awareness of this potential complication during SZC therapy.
SN - 1349-7235
SN - 0918-2918
ER -