Almanac of Clinical MedicineAlmanac of Clinical Medicine2072-05052587-9294Moscow Regional Research and Clinical Institute (MONIKI)38410.18786/2072-0505-2016-44-6-785-789Comprehensive diagnostic and medical endoscopy of gastric diseases prior to planning a surgical intervention for cardiovascular disorders: a case study of a bezoarMechevaL. V.<p class="MsoNormal"><span lang="EN-US">Mecheva Lyudmila V. – Junior Research Fellow, Endoscopy Department.</span></p><span style="font-size: 11.0pt; line-height: 115%; font-family: 'Calibri','sans-serif'; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-latin; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: minor-bidi; mso-ansi-language: EN-US; mso-fareast-language: EN-US; mso-bidi-language: AR-SA;" lang="EN-US">61/2-13 Shchepkina ul., Moscow, 129110, Russian Federation. Tel.: +7 (495) 631 05 55. E-mail: l.v.mecheva@gmail.com</span>l.v.mecheva@gmail.comTereshchenkoS. G.<span style="font-size: 11.0pt; line-height: 115%; font-family: 'Calibri','sans-serif'; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-latin; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: minor-bidi; mso-ansi-language: EN-US; mso-fareast-language: EN-US; mso-bidi-language: AR-SA;" lang="EN-US">Tereshchenko Sergey G. – MD, PhD, Head of Endoscopy Department</span>fake@neicon.ruGrigor'evN. S.<span style="font-size: 11.0pt; line-height: 115%; font-family: 'Calibri','sans-serif'; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-latin; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: minor-bidi; mso-ansi-language: EN-US; mso-fareast-language: EN-US; mso-bidi-language: AR-SA;" lang="EN-US">Grigor'ev Nikita S. – Junior Research Fellow, Department of Abdominal Surgery </span>fake@neicon.ruKaluzhskiyA. A.<span style="font-size: 11.0pt; line-height: 115%; font-family: 'Calibri','sans-serif'; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-latin; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: minor-bidi; mso-ansi-language: EN-US; mso-fareast-language: EN-US; mso-bidi-language: AR-SA;" lang="EN-US">Kaluzhskiy Anatoliy A. – MD, PhD, Associate Professor, Chair of Radiology, Postgraduate Training Faculty </span>fake@neicon.ruMoscow Regional Research and Clinical Institute, Moscow150920164467857892909201629092016Copyright © 2016, Mecheva L.V., Tereshchenko S.G., Grigor'ev N.S., Kaluzhskiy A.A.2016<p class="MsoNormal"><span lang="EN-US">Big bezoars are rare foreign bodies of the stomach. In the literature, the problem of bezoars has been described mainly as isolated clinical cases. In this publication we present a case of endoscopic removal of a big bezoar, along with the diagnostics and treatment of concomitant erosive and ulcerative lesions, as well as detection of a gastric malignancy (tubular adenoma with severely dysplastic foci). The active endoscopic approach allowed for a timely preparation of the patient for a reconstructive surgery on the low extremity vasculature. The paper may be of interest for internists, gastroenterologists, surgeons, providing them with a motivation to perform a regular follow up of upper gastrointestinal tract in patients after surgical interventions on the stomach and duodenum. This clinical observation is a good example for endoscopists of a successful diagnostics and treatment of a rare comorbid disorder.</span></p>phytobezoarendoscopic surgical procedurecardiovascular diseasegastric ulcergastric adenomaфитобезоарэндоскопическое удалениесердечно-сосудистые заболеванияязвы желудкааденома желудка[1.Соботович ДВ, Колмаков СА, Лиханов АА. Гигантский трихобезоар желудка. Сибирский медицинский журнал (Иркутск). 2010;94(3):119-20.][2. Старков ЮГ, Ветюгова ЛВ, Шишин КВ, Недо-лужко ИЮ. Удаление гигантского трихобе-зоара желудка с применением методики единого лапароскопического доступа у пациентки с синдромом Рапунцель. Эндоскопическая хирургия. 2012;18(6):15-7.][3. Джулай ГС. Безоары пищеварительного тракта: пугающие находки. Верхневолжский медицинский журнал. 2014;12(1): 40-2.][4. Erzurumlu K, Malazgirt Z, Bektas A, Dervisog-lu A, Polat C, Senyurek G, Yetim I, Ozkan K. Gastrointestinal bezoars: a retrospective analysis of 34 cases. World J Gastroenterol. 2005;11(12): 1813-7. doi: 10.3748/WJG.v11.i12.1813.][5. Nasri B, Calin M, Shah A, Gilchrist B. A rare cause of small bowel obstruction due to be-zoar in a virgin abdomen. Int J Surg Case Rep. 2016;19:144-6. doi: 10.1016/j.ijscr.2015.12.039.][6. Айзенштат АИ. К вопросу о безоарах в оперированном желудке. В: Пономарев АА, Курыгин АА. Редкие неопухолевые хирургические заболевания пищевода, желудка и двенадцатиперстной кишки. Л.: Медицина; 1987. c. 144-9.][7. Acar T, Tuncal S, Aydin R. An unusual cause of gastrointestinal obstruction: bezoar. N Z Med J. 2003;116(1173):U422.][8. Iwamuro M, Okada H, Matsueda K, Inaba T, Kusumoto C, Imagawa A, Yamamoto K. Review of the diagnosis and management of gastrointestinal bezoars. World J Gastrointest Endosc. 2015;7(4):336-45. doi: 10.4253/wjge.v7.i4.336.][9. Брегель АИ, Пинский СБ, Мутин НА, Андреев ВВ. Диагностическая и лечебная эзофагогастродуоденоскопия при инородных телах пищевода, желудка и двенадцатиперстной кишки. Сибирский медицинский журнал (Иркутск). 2000;20(1): 73-6.][10. Sharma D, Srivastava M, Babu R, Anand R, Rohtagi A, Thomas S. Laparoscopic treatment of gastric bezoar. JSLS. 2010;14(2):263-7. doi: 10.4293/108680810X12785289144566.][11. Graham DY. Nonsteroidal anti-inflammatory drugs, Helicobacter pylori, and ulcers: where we stand. Am J Gastroenterol. 1996;91(10):2080-6.]